Efficacy of yoga and its probable mechanism of action on lifestyle-related chronic kidney disease: a randomized clinical trial.

BACKGROUND: The rising incidence and debilitating impact of lifestyle-related chronic kidney disease (CKD) are alarming. Although yoga has shown favorable results in end-stage CKD, its efficacy in earlier stages remains unexamined. PURPOSE: This study assesses the efficacy and evaluates the mechanism of action of yoga on early stages of CKD. METHODS: The study followed a 2-armed randomized controlled trial design. The study was conducted at Father Muller Medical College & Hospital, Mangalore, India from January 2022 to September 2022. CKD patients (stages 3 and 4) with diabetic or hypertensive etiology, aged 35-60, were randomly allocated to the intervention (41) and control group (40). The intervention group received yoga practices for 12 weeks (5 hours/week) in addition to usual care; the control group received only usual care. Primary outcome measures included kidney function parameters, blood pressure, oxidative stress markers, antioxidant markers, and transforming growth factor-β1 (TGF-β1). RESULTS: Among the CKD participants (mean [SD], age, 54 [5.3] years; 61 [85%] males), yoga group showed significant improvement compared to the Control in serum creatinine (mean difference -0.42 (95% CI, -0.74 to -0.09); P = .013), estimated glomerular filtration rate (6.94 (95% CI, 1.76 to 12.11); P = .030), urine albumin-to-creatinine ratio (-464.2 (95% CI, -880.3 to -48.01); P = .029), and TGF-β1 (-218.2 (95% CI, -401.9 to -34.3); P = .021), along with blood pressure, oxidative-stress, and antioxidant markers. Mediation analysis demonstrates that reduced TGF-β1 levels, acting as a mediator, significantly convey the beneficial effects of yoga. CONCLUSION: The study shows the beneficial effects of 12-week yoga practice on anthropometric, biochemical, and molecular markers in patients with stages 3 and 4 CKD. These findings may encourage the integration of yoga as a potent adjunct therapy alongside usual care in the management of earlier stages of CKD.