Efeito do exercício aeróbico durante as sessões de hemodiálise na variabilidade da frequência cardíaca e na função ventricular esquerda em pacientes com doença renal crônica

Abstract

Introduction: Decreased heart rate variability (HRV) in patients with end stage renal disease (ESRD) undergoing hemodialysis is predictive of cardiac death, especially due to sudden death. Objective: To evaluate the effects of aerobic training during hemodialysis on HRV and left ventricular function in ESRD patients. Methods: Twenty two patients were randomized into two groups: exercise (n = 11; 49.6 ± 10.6 years; 4 men) and control (n = 11; 43.5 ± 12.8; 4 men). Patients assigned to the exercise group were submitted to aerobic training, performed during the first two hours of hemodialysis, three times weekly, for 12 weeks. HRV and left ventricular function were assessed by 24 hours Holter monitoring and echocardiography, respectively. Results: After 12 weeks of protocol, no significant differences were observed in time and frequency domains measures of HRV in both groups. The ejection fraction improved non-significantly in exercise group (67.5 ± 12.6% vs. 70.4 ± 12%) and decreased non-significantly in control group (73.6 ± 8.4% vs. 71.4 ± 7.6%). Conclusion: A 12-week aerobic training program performed during hemodialysis did not modify HRV and did not significantly improve the left ventricular function.

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

“…From 1,706 potential studies, 24 RCTs [3,4,5,6,7,8,9,10,11,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32] fulfilled the inclusion criteria. Kouidi et al published two duplicated studies in different magazines [3,17].…”

“…Six of the 24 studies [4,7,10,22,29,31] assessed the change in dialysis efficacy (Kt/V), with a total 233 patients; 121 patients were assigned to the exercise groups and 112 patients were assigned to the control groups. As heterogeneity was not significant (I 2 = 0%, p = 0.55), we used the Mantel-Haenszel method.…”

The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

“…Elsewhere, no serious adverse events have been reported after around 28,000 h of intradialytic exercise [13]. Moreover, ESRD patients who regularly exercise during HD improve heart rate variability, left ventricular ejection fraction and risk rating of sudden cardiac death [39,40,41]. Further research is required to delineate myocardial and vascular function during and after intradialytic exercise and the long-term impact of regular training.…”

An update on the effects of aerobic training during hemodialysis in end stage renal disease patients

“…Alguns de nossos resultados já foram publicados, porém, após julho de 2010, data final de inclusão nesta revisão. [2][3][4] Sabendo que as características das populações podem interferir nos resultados de um programa de EA, acreditamos que nossos resultados, obtidos em uma população brasileira, podem contribuir para as conclusões desta revisão que incluiu apenas estudos conduzidos em outros países.…”

“…Portanto, o EA realizado por 12 semanas não proporcionou melhora significante nos parâ-metros cardiovasculares avaliados. 2 Estes achados possivelmente estão associados com o período de realização de exercí-cios. Pacientes renais crônicos submetidos a um programa de exercício apresentam adaptações centrais como melhora cardiovascular e, principalmente, melhora nos mecanismos periféricos, representados pelo ganho muscular.…”