Cardiac autonomic function during intradialytic exercise training

Area of Science:

• Cardiology
• Nephrology
• Physiology

Background:

• Cardiac autonomic nervous system (ANS) dysfunction is prevalent in hemodialysis (HD) patients, increasing risks of arrhythmias and sudden cardiac death.
• Assessing ANS function in HD patients is crucial for risk stratification and management.

Purpose of the Study:

• To investigate and compare hemodynamic changes and ANS function responses in HD patients.
• To evaluate pupillometry and Heart Rate Variability (HRV) as tools for ANS assessment during HD, with and without intradialytic exercise.

Main Methods:

• Sixteen chronic kidney disease (CKD) patients undergoing HD were studied.
• Pupillometry and HRV analyses were performed at rest and during intradialytic aerobic exercise.
• Measurements were taken pre-HD, hourly during HD, and post-HD.

Main Results:

• No significant changes in pupillometric or HRV values were observed across measurement points during conventional HD.
• HRV and pupillometric parameters showed significant correlations pre-HD and post-exercise.
• Pupillometry indicated beneficial sympatho-vagal balance changes after intradialytic exercise.

Conclusions:

• Pupillometry is a robust technique with fewer artifacts than HRV, particularly during exercise in HD patients.
• Pupillometry shows promise as a complementary tool for evaluating cardiac autonomic dysfunction in HD patients.