P. Jharna, Sapna Kothari, V. Jyothi, P. Sai Kiran, Ashok Kothari, P. Usha Rani, P.P. Reddy


Chronic kidney disease (CKD) is affecting many individuals in the world, irrespective of ethnicity, gender and age. CKD requires dialysis or renal transplant. Haemodialysis, associated clinical conditions such as hypertension, cardiac problems, infections, headaches, muscle cramps, body pains and stigma of the disease adversely impact the survival and quality of life (QOL) despite technological advances. In addition, patients on regular haemodialysis develop sleep disorders such as insomnia and central apnea, restless leg syndrome, depression, anxiety and stress. Meditation as a complimentary therapy has been shown to decrease ones anxiety and stress, and improve comfort of patients with chronic diseases.  This review describes benefits of meditation and also introduces Arham Purushakar Meditation (APM) promoted by Upadhyay Shri. Praveen Rishiji from India, which could be easily performed without any rituals and may be practiced anywhere at any time.  The practice of APM meditation shows beneficial effects on improvement of clinical conditions and modulating anxiety and depression levels in patients undergoing haemodialysis and eventually may lead to improved QOL.

 Key words:  Chronic kidney disease (CKD), Arham Purushakar Meditation (APM), Glomerular Filtration Rate (GFR), Depression, Anxiety, Quality of life (QOL).

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Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, et al. Meditation practices for health: State of the research. Evid Rep Technol Assess (Full Rep) 2007; 155:1‑263.

Paul N Bennett, Trey Ngo Christine, KalifeBrigitte Schiller. Improving wellbeing in patients undergoing dialysis: Can meditation help?. Seminars in Dialysis. 2018; 31:59–64.

Markell MS. Complementary and alternative medicine: an overlooked adjunct for the care of patients with kidney disease. Dial Transplant. 2006; 35:724-726.

Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005; 67: 2089-2100.

Small DM, Coombes JS, Bennett N, Johnson DW, Gobe GC. Oxidative stress, anti-oxidant therapies and chronic kidney disease. Nephrology (Carlton). 2012; 17: 311-321.

Smith DH, Gullion CM, Nichols G, Keith DS, Brown JB. Cost of medical care for chronic kidney disease and comorbidity among enrollees in a large HMO population. J Am Soc Nephrol.2004; 15: 1300-1306.

Center for Disease control and prevention, CDC 24/7, National Chronic Kidney Disease Fact Sheet, 2014. Division of Diabetes Translation.

Modi GK, Jha V: The incidence of end-stage renal disease in India: a population-based study. Kidney Int.2006; 70 (12): 2131-3.

Li Y, Chen Y, Liu X, Liang Y, Shao X, et al. Metabolic Syndrome and Chronic Kidney Disease in a Southern chinese population. Nephrology.2014.

Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med. 2004; 164: 659-663.

Schlaich MP, Socratous F, Hennebry S, Eikelis N, Lambert EA, et al. Sympathetic activation in chronic renal failure. J Am Soc Nephrol. 2009; 20: 933-939.

Cachofeiro V, Goicochea M, de Vinuesa SG, Oubiña P, Lahera V, et al. Oxidative stress and inflammation, a link between chronic kidney disease and cardiovascular disease. Kidney Int Suppl. 2008; S4-9.

Wright RG, S and P, Livingston G. Psychological stress during hemodialysis for chronic renal failure. Ann Intern Med.1966; 64: 611-621.

Christensen AJ, Ehlers SL. Psychological factors in endstage renal disease: an emerging context for behavioral medicine research. J Consult Clin Psychol. 2002; 70:712-724.

Goyal M, Haythornthwaite J, Levine D, et al. Intensive meditation for refractory pain and symptoms. J Altern Complement Med. 2010; 16:627-631.

Akyol AD, Yildirim Y, Toker E, Yavuz B. The use of complementary and alternative medicine among chronic renal failure patients. J Clin Nurs. 2011; 20:1035-1043.

Ceyhan €O, G€oris S, Dogan N, Korkut Bayındır S. The use of complementary and alternative medicine by patients undergoing hemodialysis. Altern Ther Health Med. 2017; 23:40-45.

Erdogan Z, C ınar S, S ims ek S. The relationship between hopelessness level and the use of complementary medicine methods in hemodialysis patients. Spatula DD-Peer Reviewed J Complement Med Drug Discov. 2013; 3:107-112.

Rao ASA, Phaneendra D, Pavani CD, et al. Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis. J Pharm Bioallied Sci. 2016; 8:52.

Bahall M. Use of complementary and alternative medicine by patients with end-stage renal disease on haemodialysis in Trinidad: a descriptive study. BMC Complement Altern Med. 2017; 17:250.

SeH Zyoud, Al-Jabi SW, Sweileh WM, et al. Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine. BMC Complement Altern Med. 2016; 16:204.

Hart J. Complementary therapies before and after surgery. Altern Complement Ther 2009; 15:184‑8.

Creswell JD, Pacilio LE, Lindsay EK, Brown KW. Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology 2014; 44:1‑12.

Kiran U, Behari M, Venugopal P, Vivekanandhan S, Pandey R. The effect of autogenic relaxation on chronic tension headache and in modulating cortisol response. Indian J Anaesth 2005; 49: 474‑8.

Kiran U, Ladha S, Makhija N, Kapoor PM, Choudhury M, Das S, et al. The role of Rajyoga meditation for modulation of anxiety and serum cortisol in patients undergoing coronary artery bypass surgery: A prospective randomized control study. Ann Card Anaesth 2017; 20:158-62.

Cukor D, Coplan J, Brown C, et al. Depression and anxiety in urban hemodialysis patients. Clin J Am Soc Nephrol. 2007; 2:484-490.

Kimmel PL, Emont SL, Newmann JM, Danko H, Moss AH. ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. Am J Kidney Dis. 2003; 42:713-721.

Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int. 2009; 75:1223-1229.

Hedayati SS, Bosworth HB, Briley LP, et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int. 2008; 74:930-936.

Kurella M, Kimmel PL, Young BS, Chertow GM. Suicide in the United States end-stage renal disease program. J Am Soc Nephrol. 2005; 16:774-781.

Kimmel PL, Weihs K, Peterson RA. Survival in hemodialysis patients: the role of depression. J Am Soc Nephrol.1993; 4:12-27.

Binik YM, Devins GM, Barre PE, et al. Live and learn: patient education delays the need to initiate renal replacement therapy in end-stage renal disease . J Nerv Ment Dis.1993; 181:371-376.

Cukor D, Ver Halen N, Asher DR, et al,. Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. J Am Soc Nephrol. 2014; 25:196-206.

Ma SH, Teasdale JD. Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol, 2004, 72:31-40.

Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Bantam Books, 1990.

Reilly-Spong M, Reibel D, Pearson T, Koppa P, Gross CR. Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation: Trial design, rationale and feasibility. Contemp Clin Trials. 2015; 42:169-184.

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York: Guilford Press, 1979 Kidney Res Clin Pract. 2018; 37:77-84.

Bo Kyung Sohn, Yun Kyu Oh, Jung-Seok Choi, Jiyoun Song, Ahyoung Lim, Jung Pyo Lee, Jung Nam An, Hee-Jeong Choi, Jae Yeon Hwang, Hee-Yeon Jung, Jun-Young Lee, Chun Soo Lim. Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients. Kidney Res Clin. Pract. 2018; 37(1): 77-84.

Shashank Shekhar Sinha, Ajay Kumar Jain, Sanjay Tyagi, SK Gupta,and Aarti Sood Mahajan. Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease. Int J Yoga. 2018; 11(2): 122–128.

Wallace RK, Benson H, Wilson AF. A wakeful hypometabolic physiologic state. Am J Physiol. 1971; 221: 795–9.

Yi-Yuan Tang, Yinghua Ma, Junhong Wang, Yaxin Fan, Shigang Feng, Qilin Lu, Qingbao Yu, Danni Sui, Mary K. Rothbart, Ming Fan , and Michael I. Posner. Short-term meditation training improves attention and self-regulation. PNAS. 2007; 104 (43): 17152–17156.

Wallace BA, Shapiro SL. Mental balance and well-being. Am Psychol. 2006; 61:690–701.

Liu Y, Vian K, Eckman P, Fang T, Chen L. The Essential Book of Traditional Chinese Medicine (Columbia Univ Press, New York). 1988.

Maria CC, Andrade C, UrrutiaM, Sergio D, LuizA Nogueira M, Ricardo de, Cintra S Sesso; Quality of life in patients with chronic kidney disease. Clinics (Sao Paulo) 2011; 66(6):991-995.

Zoe Thomas, Mark Novak, Susanna Gabriela Torres Platas, et al. Brief Mindfulness Meditation for Depression and Anxiety symptoms in Patients Undergoing Hemodialysis. A Pilot Feasibility Study. Clinical Journal of American Society of Nephrology. 2017;7; 12 (12):2008-2015.

Hawamdeh S, Almari AM,, Asrar SA, Wireen LTD. Daterminants and prevalence of depression in patients with chronic renal disease, and their caregivers. Int J NephrolRenovasc Dis, 2017; 10:183-189. 7.

Kothari S, Kothari A, Usha Rani P, Ch. Prashanth U, Priyadarshni I, Reddy PP. A study on the effect of Arham Purushakar Meditation on well-being of patients with chronic kidney disease undergoing hemodialysis. International Journal of AYUSH.2018; 7(4) 19-26.

Rishi Praveen. Ignite Divinity. 1sted. Chennai, India: Notion 2017; p.55

Kothari S, Kothari v, and Reddy P.P., Effect of Arham Purushakar Meditation in symptomatic improvement in Patients with Renal End Stage Disease on Hemodialysis Therapy-Case Series. Int. J AYUSH CARE. 2019; 3(1): 112-117.

Philip F. Tomlinson, teacher of Transcendental Meditation(TM), from Home Dialysis Central (Website,


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