Impact of 6-week Integrated Yoga on Cardiac-Autonomic Functions and Health-Related Quality of Life among Patients with Chronic Kidney Disease Undergoing Haemodialysis- A Randomized Controlled Trial

Chronic kidney disease (CKD) is a serious global health issue, affecting 10.4% of men and 11.8% of women worldwide, with a 9.1% prevalence overall in 2017. Asia, particularly China and India, bears a significant CKD burden, with these two countries accounting for 69.1% of CKD cases in the region. In India, CKD affects 17.2% of the population, with incidence rates continuing to rise. Projections indicate that CKD may become the fifth leading cause of death globally by 2040.

CKD is marked by a gradual decline in kidney function, leading to complications and potentially end-stage kidney disease (ESKD). Its progression is influenced by molecular mechanisms such as nephron reduction, podocyte damage, and activation of EGFR signaling pathways. The disease imposes heavy economic costs, especially in developing nations where treatment options are limited. Major CKD risk factors include obesity, hypertension, diabetes, age, and high cholesterol, with hypertension and diabetes responsible for approximately 75% of cases. Additionally, CKD is linked to an elevated risk of cardiovascular disease, contributing to increased morbidity and mortality.

CKD symptoms span multiple body systems, affecting mental, neurological, cardiopulmonary, and physical health. While modern treatments aim to slow CKD progression, they largely focus on symptom management, leaving patients with significant physical, psychological, and emotional challenges. These symptoms may include depression, anxiety, cognitive impairment, fatigue, pain, sleep issues, appetite loss, muscle soreness, and compromised autonomy.

Yoga, incorporating physical postures, breathing techniques, and meditation, has been shown to improve various health outcomes in CKD patients, including reduced pain, fatigue, improved sleep, and better biochemical markers in haemodialysis patients. Practices like Yoga-Nidra, laughter yoga, and clapping exercises have demonstrated reductions in depression, anxiety, stress, blood pressure, and serum creatinine levels. Research suggests a six-month yoga program can enhance renal function and quality of life, reduce oxidative stress, and offer psychological relief. Yoga is generally safe for haemodialysis patients and may effectively complement CKD management by addressing both physical and psychological health needs, potentially leading to better health outcomes and patient satisfaction.