Is aerobic exercise training during hemodialysis a reliable intervention for autonomic dysfunction in individuals with chronic kidney disease? A prospective longitudinal clinical trial

Abstract

Mauro José de Deus Morais,1–3 Luiz Carlos de Abreu,2–4 Fabiano Santana de Oliveira,1–3 Italla Maria Pinheiro Bezerra,2,3,5 Rodrigo Daminello Raimundo,3 Romeu Paulo Martins Silva,1 Vitor Engracia Valenti,6 Andrés Ricardo Pérez-Riera2,31Centro de Saúde e Desporto, Universidade Federal do Acre, Rio Branco, Acre, Brazil; 2Laboratório de Delineamento em Pesquisas e Escrita Científica, Centro Universitário Saúde ABC Santo André, São Paulo, Brazil; 3Laboratório de Delineamento em Pesquisas e Escrita Científica, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Vitória, Espirito Santo, Brazil; 4Graduate Entry Medical School, University of Limerick, Limerick V94 T9PX, Ireland; 5Escola Superior de Ciências da Santa Casa de Misericórdia, EMESCAM, Vitória, Brazil; 6Centro de Estudos do Sistema Nervoso Autônomo, State University of São Paulo, Marília, São Paulo, BrazilCorrespondence: Mauro José de Deus MoraisCentro de Saúde e Desporto, Universidade Federal do Acre, Rua Gumercindo, nº 292, Bairro: Universitário, Rio Branco 69.917.698, Acre, BrazilTel [phone]Email [email protected] Maria Pinheiro BezerraEscola Superior de Ciências da Santa Casa de Misericórdia, EMESCAM, Bolsista Capes Brasil, Vitória, Rio Branco 69.915-900, BrazilTel [phone]Email [email protected]: Physical exercises help in the rehabilitation and recovery of various diseases. Cardiovascular and hypertension problems are the main causes of people being affected by kidney problems, which as a consequence, affects the heart rate variability (HRV) of the individual. Physical activity developed in a well-planned and thorough way can be a component in the treatment of this problem.Objective: We aimed to evaluate the effects of aerobic exercise intervention during hemodialysis on autonomic heart rate regulation in individuals with chronic kidney disease (CKD).Methods: This was a longitudinal trial conducted in 19 CKD patients. The patients underwent three weekly sessions of aerobic exercise during hemodialysis for 30 mins for 12 weeks (three months).Results: HRV was analyzed before and after the protocol training. Linear indices of HRV were not different between before and after the protocol training. Nonlinear HRV analysis indicated reduced values of determinism (p=0008, Cohen’s d=0.82) and entropy (p=003, Cohen’s d=0.84) after the training protocol.Conclusion: In conclusion, aerobic exercise training during hemodialysis did not improve autonomic control of heart rate in CKD patients.Keywords: autonomic nervous system, cardiovascular system, exercise, kidney diseases, renal dialysis

Keywords

• Autonomic Nervous System
• Cardiovascular System
• Exercise
• Kidney Diseases
• Renal Dialysis.