Health is a balance between nutrition and drainage. Just as nutrition is important for maintenance of the body, similarly elimination of waste materials, produced as a result of various physiological processes in the body, is also very important to maintain the homeostasis supporting the state of health. Excretory system in the body plays a pivotal role in waste elimination; the role of the kidney is inevitable. However, in the current scenario chronic kidney disorders are a growing concern. But the direct and indirect costs involved in the management of kidney disorders is much more cumbersome ranging from pharmacological intervention to dialysis or kidney transplant which has a grave impact on the psychological health also.
Various research has established the role of different complementary and alternative treatment modalities for kidney disorders and Yoga is one among such modalities. Yoga can contribute effectively to Primary and Secondary prevention of kidney disorders.
Considering Diabetes and Hypertension as the leading causes of kidney disorders, Yoga which can prevent these metabolic problems can reduce the risk of developing kidney disorders at the primary level. Further, as secondary prevention yoga can address the psychological symptoms like depression, anxiety, distress, and mood disturbances in the patients with kidney disorders.
Based on this understanding the yoga protocol may be followed as given below.
- Sukshma Vyayama:
This includes a set of joint specific loosening exercises involving stretching and relaxation of the joint within the normal range of movement with synchronized breathing. This helps in warming up the body before the yoga practice.
- Shitalikarana Vyayama:
A set of stretching exercises like chakki chaalan, chapathi rolling, naukasan stretch, pavanamuktasan rocking & rolling, paschimottanasana – halasana stretch etc. helps in increasing the metabolic rate, thus contributing towards obesity management, a potential risk factor for diabetes and hypertension.
- Asanas
These are the physical postures. Tadasana, Padahastasana, Ardhakati chakrasana among Standing asanas; Sasankasana, Paschimottanasana, Ardhamatsyendrasana, Vakrasana among Sitting asanas; Bhujangasana, Dhanurasana among Prone asanas; and Setubandhasana, Naukasana among Supine postures performed with awareness helps in improving metabolism and controlling diabetes. Further relaxing postures like Shavasana and Makarasana not only helps in stress control but also helps in reducing the sympathetic activation and stimulates the parasympathetic arm thereby reducing pulse rate, blood pressure, and metabolic rate.
Tadasana (Tree posture): Stand straight with legs together. Interlock the fingers of the palm and with inhalation stretch the arms upwards over the head, palms facing upwards. Coming on toes, pull the whole body upwards and hold with normal breathing. Slowly bring the hands and body back to normal position with exhalation.
Padahastasana (hand to feet pose): Stand straight with legs together, hands by the side of the body. Slowly with inhalation take both hands sideways and stretch up above the head, palms facing each other. With exhalation slowly bend the body forwards to touch the palms on the feet without bending the knee joint. Hold the position with normal breathing. Then slowly straighten up with inhalation stretching the hands up, then bring the hands down sideways with slow exhalation.
Ardhakatichakrasana (Lateral arc pose): Stand straight with legs together. With inhalation raise the right hand sideways to take it up. With exhalation bend at hip joint towards the left side and hold the position with normal breathing. Slowly with inhalation straighten the body stretching the right hand up and then with exhalation bring the hand down sideways. Repeat the same on the left side.
Sasankasana (Rabbit pose): Sit on floor with knees bend and feet under the buttocks. Take the hands backwards and hold the right wrist with the left hand. With exhalation bend forwards to touch the forehead on the floor; hold with normal breathing. With inhalation, straighten up, release the hands and legs, and relax.
Paschimottanasana (Forward bend posture): Sit on floor with legs stretched forwards. With inhalation raise the hands sideways to take them up, palms facing forwards. With exhalation bend the body forwards at the hip to catch hold of the big toe/ ankle joints with the hands, forehead on the knees. Hold with normal breathing. With inhalation straighten up stretching the hands up, with exhalation bring the hands down sideways.
Ardhamatsyendrasana: Sit on the floor with legs stretched forwards. Bend the right knee joint and place the feet under the left buttock. Bend the left knee joint and keep the feet by the outer side of the right knee joint, left knee pointing upwards. Bring the right-hand crossing over the outer aspect of the left knee joint and catch hold of the left big toe/ ankle joint. Place the left hand around the waist on the back. Hold the position and later slowly release the left hand followed by right hand, then left leg and finally the right leg. Repeat on the left side.
Vakrasana (Twisted pose): Sit on the floor with legs stretched out. Slowly bend the right leg and place the feet adjacent to the left knee joint, right knee joint pointing upwards. Place the right palm backwards in line with the right feet. With the left hand crossing over the outer aspect of the right knee joint, hold the right big toe/ ankle joint giving a good twist to the middle part of the body, face turned towards right. Hold and then release starting with the left hand, then right hand and then the right leg.
Bhujangasana (Cobra pose): Lie prone on the floor. Keep palms on either side of the chest and with inhalation slowly raise the upper part of the body up to the naval region. Hold and then slowly drop the body down with exhalation.
Dhanurasana (Bow pose): Lie prone and bend the knee joints and catch hold of the ankle joints with respective hands. Inhale and stretch out the body into a bow shape, hold and then slowly release with exhalation and return to a prone position.
Setubandhasana (Bridge pose): Lie supine on floor and bend the knee joints to keep the heels close to buttocks, knee joints pointing upwards. Supporting the hips with the hands, lift the middle part of the body upwards. Hold and then slowly release and return to supine posture.
Naukasana (Boat pose): Lie supine on floor and slowly lift the legs to 45 degrees. Also lift the upper part of the body with hands stretching forwards. Body assumes the shape of a boat. Hold and then gradually release.
- Pranayama:
Breathing practices like Chandraanuloma villoma stimulates the parasympathetic component of autonomic nervous system, Bhramari helps in creating mindful relaxation with stimulation of higher control centers in the brain, cooling Pranayama like Shithali and Sitkari also effective in controlling blood pressure.
Chandranuloma Viloma Pranayama: Chandra nadi refers to Left nostril. Adopting nasika mudra in the right hand, gently close the righ