Role of Meditation in Reducing Sympathetic Hyperactivity and Improving Quality of Life in Lupus Nephritis Patients with Chronic Kidney Disease
Sirawit Bantornwan MD*, Wattana B Watanapa MD, PhD**, Poungpetch Hussarin BEd**, Somruedee Chatsiricharoenkul MD***, Nuttasith Larpparisuth MD*, Tanyarat Teerapornlertratt MD*, Jutamas Vareesangthip Dr****, Kriengsak Vareesangthip MD*
Affiliation : * Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *** Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand **** Graduate School, Mahachulalongkornrajavidyalaya, Bangkok, Thailand
Background : Lupus nephritis is an important leading cause of chronic kidney disease (CKD) among the young population
in Thailand. Systemic lupus erythematosus (SLE) is often characterized by the presence of sympathetic hyperactivity, which
results in a perishing outcome. Some physiological studies reveal that meditation may reduce this autonomic dysfunction. The
authors hypothesized that meditation could be beneficial in alleviating the sympathetic hyperactivity and improving quality of
life in lupus nephritis patients with CKD.
Material and Method: The authors performed a prospective pilot study, which enrolled lupus nephritis patients and categorized
enrollees into meditation group and control group. Method of meditation was instructed by an expert in Buddhist studies for
a duration of 60 minutes every month. Participants in the intervention group were advised to meditate every day for 24 weeks.
To evaluate change in sympathetic activity, normetanephrine level was measured at beginning and the end of study and
compared between both groups. Quality of life was determined by SF-36. Heart rate variability was also assessed in
meditation group.
Results : Thirty eligible patients were recruited into the study. Fifteen patients were stratified in the meditation group and 15
patients in the control group. After meditation for 6 months, serum normetanephrine level decreased, but without statistical
significance (0.105 vs. 0.059, p = 0.28). The reduction in normetanephrine level was also observed in the control group (p
= 0.11). In the aspect of quality of life, scores of physical and mental components improved significantly. In meditation group,
physical component score increased from 21.4 (5.0-50.2) to 62.2 (51.8-88.4) points (p<0.01) and mental score increased
from 16.9 (4.4-46.0) to 72.4 (45.1-81.6) points (p<0.01). Quality of life score in the meditation group significantly increased
more than in control group (p<0.01). The parameter of heart rate variability in time and frequency domain also improved in
the meditation group.
Conclusion : In lupus nephritis patients with CKD, meditation shows a trend of benefits in reducing sympathetic overactivity
and improving quality of life. Our results support the important role of meditation as a valuable adjunctive treatment of lupus
nephritis with CKD.
Keywords : Meditation, Sympathetic hyperactivity, Quality of life, Chronic kidney disease, Normetanephrine, Heart rate variability
