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

Abstract 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.