# Effects of Yoga and naturopathic intervention on cardiac autonomic functions in chronic kidney disease with coronary artery disease – A Case Series

## TL;DR

A 15-day yoga and naturopathic program improved heart function in patients with kidney disease and heart disease, suggesting complementary benefits.

## Contribution

This case series demonstrates that integrative yoga and naturopathic interventions can improve autonomic cardiac function in CKD and CAD patients.

## Key findings

- Heart rate variability markers improved significantly in all four patients after the intervention.
- The LF/HF ratio normalized in some cases, indicating better autonomic regulation.
- Stress Index and RMSSD values showed enhanced parasympathetic activity post-intervention.

## Abstract

Chronic kidney disease (CKD) and coronary artery disease (CAD) are significant global health challenges with high mortality rates. Conventional treatments often yield limited satisfaction, necessitating exploration of integrative therapeutic approaches. Four patients (3 males, 1 female; ages 39–56) with confirmed CKD (eGFR <15 ml/min) and CAD were enrolled. Patients presented with symptoms including breathing difficulties, chest heaviness, and reduced cardiac function, and were unsatisfied with previous conventional treatments. Patients underwent a 15-day intense program combining yoga, acupuncture, hydrotherapy, manipulative therapy, and specialised naturopathic diet. Daily yoga sessions lasted 60–75 minutes and included specific asanas, breathing techniques and relaxation practices. Heart rate variability (HRV) analysis revealed significant improvements across multiple autonomic function markers, observed across all patients. Mean RR intervals increased, with case 3 rising from 582 ms to 675 ms. RMSSD improved from 22.5 ms to 46.9 ms in case 1, indicating enhanced parasympathetic activity. The Stress Index decreased across all cases, most notably in case 3 from 96.4 to 44.8. The LF/HF ratio approached more balanced levels, with case 3 moving from 2.633 to 0.995, suggesting improved autonomic regulation. The integrated yoga and naturopathic intervention demonstrated potential in improving cardiac autonomic functions in CKD and CAD patients. Results suggest these complementary approaches may offer a promising adjunct to conventional medical management by modulating autonomic nervous system activity.