A systematic review and meta-analysis investigating the impact of exercise interventions on heart rate variability in hemodialysis patients

Patients with chronic kidney disease have a high incidence of cardiovascular diseases, and autonomic dysfunction has a determinant role in the relevant declines. Physical exercise influences heart rate variability and cardiac autonomic modulation. Thus, our objective was to systematically review, with a meta-analysis, the correlation between physical exercise interventions and alterations in cardiac autonomic modulation in hemodialysis patients. A customized research strategy was used across four databases. The search yielded 392 studies, with eight randomized clinical trials included (396 participants), indicating that the investigated indices favor the intervention group by increasing autonomic activity. The exercise training probably increases the standard deviation of all NN intervals (20.71 ms CI 95% [9.55, 31.87], p