RESUMEN

Objetivo: avaliar os efeitos de um programa de exercício resistido intradialítico sobre a qualidade do sono e a modulação autonômica cardíaca de pacientes em hemodiálise. Método: ensaio clínico não randomizado, realizado entre fevereiro de 2019 e outubro de 2020, com 52 indivíduos renais crônicos dialíticos, alocados em grupo intervenção (GI; n=32) e grupo controle (GC; n=20). O GI realizou 12 semanas de treinamento físico intradialítico, três vezes por semana. Foram mensurados índices de qualidade do sono e modulação autonômica cardíaca. Resultados: houve incremento nos índices desvio padrão dos intervalos batimento a batimento (SDNN) (ms) (p=0,0004), raiz quadrada da média do quadrado dos intervalos batimento a batimento adjacentes (RMSSD) (ms) (p<0,0001), desvio padrão 1 (SD1) (ms) (p=0,03) e razão desvio padrão 1/desvio padrão 2 (SD1/SD2) (p=0,0003). Não houve melhora da qualidade do sono. Conclusão: O exercício resistido intradialítico, é capaz de melhorar a modulação autonômica cardíaca em pacientes com doença renal crônica(AU)

Objective: to evaluate the effects of an intradialytic resistance exercise program on sleep quality and cardiac autonomic modulation in hemodialysis patients. Method: non-randomized clinical trial, carried out between February 2019 and October 2020, with 52 individuals with chronic renal failure on dialysis, divided into an intervention group (IG; n=32) and a control group (CG; n=20). The IG performed 12 weeks of intradialytic physical training, three times a week. Indices of sleep quality and cardiac autonomic modulation were measured. Results: there was an increase in the standard deviation indices of beat-to-beat intervals (SDNN) (ms) (p=0.0004), square root of the mean square of adjacent beat-to-beat intervals (RMSSD) (ms) (p<0. 0001), standard deviation 1 (SD1) (ms) (p=0.03) and standard deviation 1/standard deviation 2 (SD1/SD2) ratio (p=0.0003). There was no improvement in sleep quality. Conclusion: Intradialytic resistance exercise is able to improve cardiac autonomic modulation in patients with chronic kidney disease(AU)

Objetivo: evaluar los efectos de un programa de ejercicios de resistencia e intradialíticos sobre la calidad del sueño y la modulación autonómica cardíaca en pacientes en hemodiálisis. Método: ensayo clínico no aleatorizado, realizado entre febrero de 2019 y octubre de 2020, junto a 52 individuos en diálisis con insuficiencia renal crónica, divididos en grupo intervención (GI; n=32) y grupo control (GC; n=20). El GI realizó 12 semanas de entrenamiento físico intradialítico, tres veces por semana. Se midieron índices de calidad del sueño y modulación autonómica cardíaca. Resultados: hubo un aumento en los índices de desviación estándar de los intervalos entre latidos (SDNN) (ms) (p=0,0004), raíz cuadrada del cuadrado medio de los intervalos entre latidos adyacentes (RMSSD) (ms) (p<0,0001), desviación estándar 1 (DE1) (ms) (p=0,03) y relación desviación estándar 1/desviación estándar 2 (DE1/DE2) (p=0,0003). No hubo mejoría en la calidad del sueño. Conclusión: el ejercicio de resistencia intradialítico puede mejorar la modulación autonómica cardíaca en pacientes con enfermedad renal crónica(AU)

Asunto(s)

RESUMEN

Objectives: Sleep disorders in patients on hemodialysis are frequent, but few studies correlate these disorders with autonomic dysfunction in these patients. This study aimed to verify whether clinical and laboratory variables and heart rate variability are associated with worse sleep quality verified by the Pittsburg subjective scale in patients on hemodialysis. Material and Methods: A cross-sectional study was performed on forty-eight patients. Epidemiological, clinical, and laboratory data were collected. After were performed by recording the heart rate variability and applied Pittsburg questionnaires, Beck anxiety index (BAI), and Beck depression index (BDI). The global PSQI score >5 indicates that a person is a poor sleeper, the patients were divided according to the scores in the Pittsburg questionnaire into good and poor sleepers and the differences between all variables were analyzed. Results: Forty-eight patients were evaluated and the prevalence of 68.7% (n=33) of poor sleep quality was verified. From the depression and anxiety questionnaires, it was found that only 18.7% (n=9) had criteria for depression. In the analysis of the sympathetic dysfunction parameters, it was found that in the group with good sleep quality in the frequency domain (HFm2) and the LFnu in the group with worse sleep quality. There was a positive correlation between sleep quality scores the anxiety and depression scores. It is also verified that the variables LFnu had a positive correlation with higher scores of quality of sleep and HFnu had a negative correlation with the highest scores of quality of sleep. Conclusion: In patients undergoing hemodialysis, the poorest quality of sleep is correlated with worse cardiac autonomic modulation as well as higher scores on the depression and anxiety scales.

Asunto(s)

RESUMEN

BACKGROUND: Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents. METHODS: The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio. RESULTS: Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively. CONCLUSIONS: The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.

Asunto(s)

RESUMEN

We aimed to analyze the effect of an exercise training program in autonomic modulation, and exercise tolerance of hemodialysis and kidney-transplanted patients. 4 groups of exercised and non-exercised patients undergoing hemodialysis and kidney-transplanted subjects had their biochemical tests, and heart rate variability evaluations analyzed. Also, sleep quality, anxiety and depression questionnaires were evaluated. Both exercised groups showed improvements in cardiovascular autonomic modulation, biochemical markers, and exercise tolerance after the exercise training program. The exercised kidney-transplanted patients group showed better improvements in cardiovascular autonomic modulation, biochemical markers, and exercise tolerance when compared to the exercised hemodialysis patients group. Both groups showed improvements in sleep quality, anxiety, and depression. The group of kidney-transplanted patients show better results in the cardiovascular autonomic modulation than subjects undergoing hemodialysis. However, the patients undergoing hemodialysis showed improvements in blood pressure, HDL, hemoglobin and phosphorus, changes not observed in the kidney-transplanted group. Exercise is beneficial for both hemodialysis and kidney-transplanted patients groups. However, exercise programs should be focused mainly in improving cardiovascular risk factors in the HD patients.

Asunto(s)

RESUMEN

The aim of this study was to compare the sleep quality, depression, anxiety, and autonomic function of a group of kidney-transplanted recipients who joined a combined exercise program (KTRt) or remained sedentary (KTRs). A total of 20 kidney-transplanted recipients, split into two groups (10 KTRt and 10 KTRs), joined the study. Heart rate variability, cardiorespiratory capacity, depression, and sleep questionnaires were evaluated. KTRt presented lower Pittsburgh Sleep Quality Index and greater entropy, and increased parasympathetic and decreased sympathetic modulation than KTRs. Anxiety level was minimal and depression was absent in both groups. KTRt group presented better sleep quality and better autonomic modulation than KTRs.

Asunto(s)

RESUMEN

Modulation of the autonomic nervous system on heart rate can be compromised in chronic kidney disease and may result in changes in the frequency and duration of the cardiac cycle. The aim of this study was to evaluate autonomic modulation in active and sedentary renal transplant recipients. Twenty renal-transplanted individuals were analyzed at the Centro de Prevenção de Doenças Renais (Kidney Disease Education Centre), in the academic hospital of Universidade Federal do Maranhão, and were divided into the active group (AG) and the sedentary group (SG). The AG comprised of six men and four women (age 43.10 ± 13.02) and was in regular concurrent training intervention for 8 weeks, while the SG was composed of three men and seven women (age 36.8 ± 9.26). Analysis of heart rate (HR) variability in time and frequency domain demonstrated that HR mean values in the SG and AG were 787.32 ± 79.60 and 870 ± 106.66 ms, respectively. Differences were observed in the time domain and frequency domain. The total index of low frequency and high frequency showed no differences between the SG and AG. Biochemical variables presented significantly lower levels after 8 weeks of training. Higher heart rate variability in the time domain and greater vagal modulation was observed in the AG. The AG ad greater vagal modulation when compared to the SG, with removal of the sympathetic and increased parasympathetic in the behaviour was confirmed by sympatho-vagal balance. The AG also presented significant improvements in the frequency domain.

Asunto(s)