GENERAL PRINCIPLES OF USE OF DOSED PHYSICAL EXERCISE IN PATIENTS WITH HEMODIALYSIS

The article reflects modern ideas about the causes and mechanisms of the physical functioning disorders in patients with chronic kidney disease receiving program hemodialysis. Various types of physical activity are considered and the rationale for their use in dialysis patients is justified. The diagnostics possibilities of the protein- energy deficiency main variants are presented. Possible directions for their correction are outlined. The possibilities and methods of regular physical training in such a complex cohort of patients with changes in almost all the basic systems of the body are described in detail. For patients who cannot perform physical exercises in a training mode, a new rehabilitation technique was developed and tested on a representative sample, and a new rehabilitation technique that was not previously used in nephrology – a cutaneous bilateral electrostimulation of the muscles of the lower extremities – was justified and considered in detail. The authors give their own data on long-term follow-up of patients, which confirm the possibilities of the presented methods not only in terms of improving physical performance, but also in improving the adequacy of dialysis and the quality of life.