Efeito do exercício aeróbio na modulação autonômica cardíaca de pacientes com doença renal crônica em hemodiálise: revisão sistemática e metanálise

Abstract

People with chronic kidney disease on hemodialysis face higher probability of death, explained in part by cardiac autonomic dysfunction. On the other hand, aerobic training improves the prognosis of these patients. Therefore, the aim of this study was to investigate the effect of the aerobic training on cardiac autonomic modulation in people with chronic kidney disease undergoing hemodialysis. The databases used were PubMed, MEDLINE, Embase, Web of Science and Cochrane Library. Studies that measured heart rate variability parameters before and after aerobic training in people with chronic kidney disease undergoing hemodialysis were selected. Four studies met the eligibility criteria, and three studies entered the meta-analysis, totaling 185 patients on hemodialysis for more than 6 years, with 3 sessions per week lasting 4 hours each. The aerobic training was performed during the first two hours of the hemodialysis session in 3 studies, and one study performed training during the interdialytic period. The metaanalysis showed improvement in heart rate variability, with increased vagal modulation after aerobic training compared to the sedentary group (-0.41 [0.24, 0.59]; I²=0.00%; p<0,001). We observed that the aerobic training improved the autonomic modulation of people with chronic kidney disease undergoing hemodialysis.