{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:54:41Z","timestamp":1791456881903,"version":"4.3.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Department of Science & Technology, India","award":["DST\/SATYAM\/2018\/13(G))"],"award-info":[{"award-number":["DST\/SATYAM\/2018\/13(G))"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study assesses the efficacy and evaluates the mechanism of action of yoga on early stages of CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study followed a 2-armed randomized controlled trial design. The study was conducted at Father Muller Medical College &amp; 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\u2009weeks (5\u2009hours\/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-\u03b21 (TGF-\u03b21).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 \u22120.42 (95% CI, \u22120.74 to \u22120.09); P\u2009=\u2009.013), estimated glomerular filtration rate (6.94 (95% CI, 1.76 to 12.11); P\u2009=\u2009.030), urine albumin-to-creatinine ratio (\u2212464.2 (95% CI, \u2212880.3 to \u221248.01); P\u2009=\u2009.029), and TGF-\u03b21 (\u2212218.2 (95% CI, \u2212401.9 to \u221234.3); P\u2009=\u2009.021), along with blood pressure, oxidative-stress, and antioxidant markers. Mediation analysis demonstrates that reduced TGF-\u03b21 levels, acting as a mediator, significantly convey the beneficial effects of yoga.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/abm\/kaaf101","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T12:26:26Z","timestamp":1767011186000},"source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of yoga and its probable mechanism of action on lifestyle-related chronic kidney disease: a randomized clinical trial"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1364-3008","authenticated-orcid":false,"given":"Rajesh G","family":"Nair","sequence":"first","affiliation":[{"name":"Molecular Bioscience Lab, Anvesana Research Labs, S-VYASA [Deemed to be University] , Bangalore 560105,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Mavathur","sequence":"additional","affiliation":[{"name":"Anvesana Research Labs, S-VYASA [Deemed to be University] , Bangalore 560105,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N K","family":"Manjunath","sequence":"additional","affiliation":[{"name":"Division of Yoga & Life Sciences, S-VYASA [Deemed to be University] , Bangalore 560105,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Manjunath","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Father Muller Medical College & Hospital , Mangalore 575004,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"2026100806270078400_kaaf101-B1","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/S0140-6736(13)60687-X","article-title":"Global kidney disease 3 chronic kidney disease: global dimension and perspectives","volume":"382","author":"Jha","year":"2013","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B2","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic kidney disease","volume":"389","author":"Webster","year":"2017","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B3","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1001\/jama.2019.14745","article-title":"Chronic kidney disease diagnosis and management: a review","volume":"322","author":"Chen","year":"2019","journal-title":"JAMA"},{"key":"2026100806270078400_kaaf101-B4","doi-asserted-by":"crossref","first-page":"e0158765","DOI":"10.1371\/journal.pone.0158765","article-title":"Global prevalence of chronic kidney disease\u2014a systematic review and meta-analysis","volume":"11","author":"Hill","year":"2016","journal-title":"PLoS One"},{"key":"2026100806270078400_kaaf101-B5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41581-020-00363-6","article-title":"Sustainable development goals relevant to kidney health: an update on progress","volume":"17","author":"Luyckx","year":"2021","journal-title":"Nat Rev Nephrol"},{"key":"2026100806270078400_kaaf101-B6","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the global burden of disease study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B7","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016\u201340 for 195 countries and territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B8","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/S0140-6736(19)32977-0","article-title":"The global burden of chronic kidney disease","volume":"395","author":"Cockwell","year":"2020","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B9","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.kint.2023.12.003","article-title":"Mind the gap in kidney care: translating what we know into what we do","volume":"105","author":"Luyckx","year":"2024","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B10","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/kisup.2013.3","article-title":"Current status of end-stage renal disease care in India and Pakistan","volume":"3","author":"Jha","year":"2013","journal-title":"Kidney Int Suppl (2011)"},{"key":"2026100806270078400_kaaf101-B11","doi-asserted-by":"crossref","first-page":"100438","DOI":"10.1016\/j.lanepe.2022.100438","article-title":"Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2\u00b74 million patients from 11 countries: the CaReMe CKD study","volume":"20","author":"Sundstr\u00f6m","year":"2022","journal-title":"Lancet Reg Health Eur"},{"key":"2026100806270078400_kaaf101-B12","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1038\/nrneph.2015.114","article-title":"Management of hypertension in chronic kidney disease","volume":"11","author":"Townsend","year":"2015","journal-title":"Nat Rev Nephrol"},{"key":"2026100806270078400_kaaf101-B13","first-page":"1","article-title":"Pathogenic role of TGF- \u03b2 in diabetic nephropathy","volume":"9","author":"Lee","year":"2013","journal-title":"J Diabetes Metab"},{"key":"2026100806270078400_kaaf101-B14","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.kint.2022.05.012","article-title":"Molecular mechanisms and therapeutic targets for diabetic kidney disease","volume":"102","author":"Tuttle","year":"2022","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B15","doi-asserted-by":"crossref","first-page":"7047238","DOI":"10.1155\/2016\/7047238","article-title":"Oxidative stress in diabetic nephropathy with early chronic kidney disease","volume":"2016","author":"Miranda-D\u00edaz","year":"2016","journal-title":"J Diabetes Res"},{"key":"2026100806270078400_kaaf101-B16","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.semnephrol.2007.01.006","article-title":"AGE, RAGE, and ROS in diabetic nephropathy","volume":"27","author":"Tan","year":"2007","journal-title":"Semin Nephrol"},{"key":"2026100806270078400_kaaf101-B17","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1159\/000087339","article-title":"Cell biology of diabetic kidney disease","volume":"101","author":"Kanwar","year":"2005","journal-title":"Nephron Exp Nephrol"},{"key":"2026100806270078400_kaaf101-B18","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1053\/j.ajkd.2013.10.047","article-title":"New insights into molecular mechanisms of diabetic kidney disease","volume":"63","author":"Badal","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"2026100806270078400_kaaf101-B19","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1038\/nrneph.2016.48","article-title":"TGF-\u03b2: the master regulator of fibrosis","volume":"12","author":"Meng","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"2026100806270078400_kaaf101-B20","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S1359-6101(99)00035-0","article-title":"TGF-\u03b2 in diabetic kidney disease: role of novel signaling pathways","volume":"11","author":"Sharma","year":"2000","journal-title":"Cytokine Growth Factor Rev"},{"key":"2026100806270078400_kaaf101-B21","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/jhh.2013.55","article-title":"Hypertension and kidneys: unraveling complex molecular mechanisms underlying hypertensive renal damage","volume":"28","author":"Mennuni","year":"2013","journal-title":"J Hum Hypertens"},{"key":"2026100806270078400_kaaf101-B22","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1681\/ASN.2010040384","article-title":"Angiotensin II as a morphogenic cytokine stimulating renal fibrogenesis","volume":"22","author":"R\u00fcster","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"2026100806270078400_kaaf101-B23","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/S0140-6736(21)00519-5","article-title":"Chronic kidney disease","volume":"398","author":"Kalantar-Zadeh","year":"2021","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B24","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0140-6736(13)60438-9","article-title":"Kidney failure: Aims for the next 10 years and barriers to success","volume":"382","author":"Remuzzi","year":"2013","journal-title":"Lancet"},{"key":"2026100806270078400_kaaf101-B25","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1089\/acm.2015.0057","article-title":"Yoga as a therapeutic intervention: a bibliometric analysis of published research studies from 1967 to 2013","volume":"21","author":"Jeter","year":"2015","journal-title":"J Altern Complement Med"},{"key":"2026100806270078400_kaaf101-B26","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s13410-012-0078-y","article-title":"Efficacy of yoga based life style modification program on medication score and lipid profile in type 2 diabetes-a randomized control study","volume":"32","author":"Nagarathna","year":"2012","journal-title":"Int J Diabetes Dev Ctries"},{"key":"2026100806270078400_kaaf101-B27","doi-asserted-by":"crossref","first-page":"6979370","DOI":"10.1155\/2016\/6979370","article-title":"Yoga for adults with type 2 diabetes: a systematic review of controlled trials","volume":"2016","author":"Innes","year":"2016","journal-title":"J Diabetes Res"},{"key":"2026100806270078400_kaaf101-B28","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1097\/01.hjh.0000935436.35268.42","article-title":"Effect of doing yoga for 1 month to systolic and diastolic blood pressure: a system overview and meta analysis","volume":"41","author":"Pintaningrum","year":"2023","journal-title":"J Hypertens"},{"key":"2026100806270078400_kaaf101-B29","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.mayocp.2018.09.023","article-title":"Yoga as antihypertensive lifestyle therapy: a systematic review and meta-analysis","volume":"94","author":"Wu","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"2026100806270078400_kaaf101-B30","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.ctim.2006.06.008","article-title":"A modified yoga-based exercise program in hemodialysis patients: a randomized controlled study","volume":"15","author":"Yurtkuran","year":"2007","journal-title":"Complement Ther Med"},{"key":"2026100806270078400_kaaf101-B31","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/0973-6131.105944","article-title":"Effect of yoga exercise therapy on oxidative stress indicators with end-stage renal disease on hemodialysis","volume":"6","author":"Gordon","year":"2013","journal-title":"Int J Yoga"},{"key":"2026100806270078400_kaaf101-B32","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2022.06.008","article-title":"KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease","volume":"102","author":"Rossing","year":"2022","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B33","first-page":"32","article-title":"Yoga and hypertension: a systematic review","volume":"20","author":"Tyagi","year":"2014","journal-title":"Altern Ther Health Med"},{"key":"2026100806270078400_kaaf101-B34","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1053\/j.ajkd.2014.01.416","article-title":"KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD","volume":"63","author":"Inker","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"2026100806270078400_kaaf101-B35","doi-asserted-by":"crossref","first-page":"E35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of blood pressure in humans: a scientific statement from the American Heart Association","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"key":"2026100806270078400_kaaf101-B36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v048.i02","volume":"48","author":"Rosseel","year":"2012","journal-title":"J Stat Softw."},{"key":"2026100806270078400_kaaf101-B37","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3200\/JOER.99.6.323-338","article-title":"Reporting structural equation modeling and confirmatory factor analysis results: a review","volume":"99","author":"Schreiber","year":"2006","journal-title":"J Educ Res"},{"key":"2026100806270078400_kaaf101-B38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/0973-6131.186158","article-title":"Effects of 6 months yoga program on renal functions and quality of life in patients suffering from chronic kidney disease","volume":"10","author":"Pandey","year":"2017","journal-title":"Int J Yoga"},{"key":"2026100806270078400_kaaf101-B39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/945895","article-title":"Overview of systematic reviews: yoga as a therapeutic intervention for adults with acute and chronic health conditions","volume":"2013","author":"McCall","year":"2013","journal-title":"Evid Based Complement Alternat Med"},{"key":"2026100806270078400_kaaf101-B40","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1471-2261-13-111","article-title":"Impact of yoga on blood pressure and quality of life in patients with hypertension\u2014a controlled trial in primary care, matched for systolic blood pressure","volume":"13","author":"Wolff","year":"2013","journal-title":"BMC Cardiovasc Disord"},{"key":"2026100806270078400_kaaf101-B41","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1681\/ASN.2020030384","article-title":"Modifiable lifestyle factors for primary prevention of CKD: a systematic review and meta-analysis","volume":"32","author":"Kelly","year":"2021","journal-title":"J Am Soc Nephrol"},{"key":"2026100806270078400_kaaf101-B42","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1053\/j.ajkd.2014.09.016","article-title":"Healthy lifestyle and risk of kidney disease progression, atherosclerotic events, and death in CKD: findings from the chronic renal insufficiency cohort (CRIC) study","volume":"65","author":"Ricardo","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"2026100806270078400_kaaf101-B43","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.kint.2020.08.012","article-title":"Multifactorial intervention has a significant effect on diabetic kidney disease in patients with type 2 diabetes","volume":"99","author":"Ueki","year":"2021","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B44","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1038\/ki.2014.370","article-title":"Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus","volume":"87","author":"Dunkler","year":"2015","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B45","doi-asserted-by":"crossref","first-page":"752","DOI":"10.3390\/antiox9080752","article-title":"Chronic kidney disease as oxidative stress- and inflammatory-mediated cardiovascular disease","volume":"9","author":"Podkowi\u0144ska","year":"2020","journal-title":"Antioxidants"},{"key":"2026100806270078400_kaaf101-B46","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1046\/j.1523-1755.2000.00328.x","article-title":"Effects of diabetes and hypertension on glomerular transforming growth factor-\u03b2 receptor expression","volume":"58","author":"Kang","year":"2000","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B47","doi-asserted-by":"crossref","first-page":"3151","DOI":"10.2337\/db13-0305","article-title":"Transforming growth factor-\u03b2\u2013induced cross talk between p53 and a microRNA in the pathogenesis of diabetic nephropathy","volume":"62","author":"Deshpande","year":"2013","journal-title":"Diabetes"},{"key":"2026100806270078400_kaaf101-B48","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1038\/ki.2015.51","article-title":"Renal fibrosis is not reduced by blocking transforming growth factor-\u03b2 signaling in matrix-producing interstitial cells","volume":"88","author":"Neelisetty","year":"2015","journal-title":"Kidney Int"},{"key":"2026100806270078400_kaaf101-B49","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4172\/2157-7595.1000186","article-title":"Development of an intra-dialysis yoga protocol for patients with end-stage renal disease","volume":"5","author":"Birdee","year":"2015","journal-title":"J Yoga Phys Ther"},{"key":"2026100806270078400_kaaf101-B50","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ekir.2022.11.007","article-title":"A pilot randomized trial of intradialysis yoga for patients with end-stage kidney disease","volume":"8","author":"Herron","year":"2023","journal-title":"Kidney Int Rep"},{"key":"2026100806270078400_kaaf101-B51","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.kint.2019.12.002","article-title":"Kidney health for everyone everywhere\u2014from prevention to detection and equitable access to care","volume":"97","author":"Li","year":"2020","journal-title":"Kidney Int"}],"container-title":["Annals of Behavioral Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/abm\/article-pdf\/60\/1\/kaaf101\/68412173\/kaaf101.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/abm\/article-pdf\/60\/1\/kaaf101\/68412173\/kaaf101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:27:17Z","timestamp":1791455237000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/abm\/article\/doi\/10.1093\/abm\/kaaf101\/8439293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":51,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,7]]}},"URL":"https:\/\/doi.org\/10.1093\/abm\/kaaf101","relation":{},"ISSN":["1532-4796"],"issn-type":[{"value":"1532-4796","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"kaaf101"}}