End-Stage Renal Disease Intra-dialysis Lifestyle Education Study

The investigators propose a prospective, randomized clinical trial among on maintenance hemodialysis to compare the effects of intra-dialysis yoga to an educational program. In a sample of 68 patients the investigators will compare the clinical effects of a 12-week program of yoga to a 12-week education program during dialysis. Outcome assessment of study participants will occur at baseline, 6-weeks, 12-weeks, and 24 weeks for: disease-related quality of life (physical component primary outcome of the study), physical performance, blood pressure, fatigue, satisfaction with dialysis, sleep quality, and mood. Among a sub-sample of 20 participants, the investigators will measure the potential effects of the interventions on endothelial function, arterial stiffness, and autonomic tone. The sub-study will collect outcomes at baseline and 12 weeks.

Inclusion criteria

• Maintenance hemodialysis for ≥3 or months
• Adequately dialyzed (Kt/V ≥1.2 measured within last 3 months)
• Expected to remain in present hemodialysis shift for next 4 months
• Expected to remain on hemodialysis for at least 6 months
• 18 years or older

Exclusion criteria

• Acute or chronic medical conditions that would make intra-dialysis yoga potentially hazardous
• Unstable cardiac disease e.g. angina, life threatening arrhythmia
• Chronic lung disease that prevents gentle exercise or deep breathing exercises
• Active cerebrovascular disease
• Major depression
• Chronic symptoms of nausea, vomiting, or diarrhea
• Current participation in exercise or mind body program/practice
• Cognitive impairment (MME ≤ 24) measured at baseline testing visit