Autonomic Modulation with Mindfulness-Based Stress Reduction in Chronic Kidney Disease: A Randomized Controlled Trial
Jinhee Jeong, Yingtian Hu, Matias Zanuzzi, Dana DaCosta, Sabrina Li, Jeanie Park
preprint DOI: 10.1101/2024.04.17.24306000 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial |
|---|---|
| Sample size | 28 |
| Population | Adults with chronic kidney disease stages III-IV (mean age 63 years, 86% male) |
| Intervention | Mindfulness-Based Stress Reduction (MBSR) |
| Duration | 8-week intervention |
| Measures | muscle sympathetic nerve activity (MSNA) via microneurography |
| Topics | Meditation |
| Key findings | Eight weeks of Mindfulness-Based Stress Reduction reduced sympathetic nerve reactivity to mental stress in chronic kidney disease patients, with mean MSNA change falling from 10.6 to 5.0 bursts/min, while the active control group showed no change. The authors conclude that mindfulness training is feasible and may have clinically beneficial effects on autonomic function in this population. |
Abstract
Abstract Background Chronic kidney disease (CKD) is characterized by overactivation of the sympathetic nervous system (SNS) that leads to increased cardiovascular disease risk. Despite the deleterious consequences of SNS overactivity, there are very few therapeutic options available to combat sympathetic overactivity.
Aim: To evaluate the effects of Mindfulness-Based Stress Reduction (MBSR) on SNS activity in CKD patients.
Method: Participants with CKD stages III-IV were randomized to an 8-week MBSR program or Health Education Program (HEP; a structurally parallel, active control group). Primary outcomes were direct intraneural measures of SNS activity directed to muscle (MSNA) via microneurography at rest and during stress maneuvers.
Results: 28 participants (63 ±9 years; 86% males) completed the intervention with 16 in MBSR and 12 in HEP. There was a significant Group (MBSR vs. HEP) by Time (baseline vs. post-intervention) interaction in the change in MSNA reactivity to mental stress (p=0.026), with a significant reduction in the mean change in MSNA over 3 minutes of mental arithmetic at post-intervention (10.6 ± 7.1 to 5.0 ± 5.7 bursts/min, p<0.001), while no change was observed within the HEP group (p=0.773).
Conclusions: In this randomized controlled trial, patients with CKD had an amelioration of sympathetic reactivity during mental stress following 8-weeks of MBSR but not after HEP. Our findings demonstrate that mindfulness training is feasible and may have clinically beneficial effects on autonomic function in CKD.