Purpose of Review-Patients with CKD endure compromised health-related quality of life (HRQOL). Although the link between HRQOL and increased mortality in ESRD patients is welldocumented, less is known about the relationship between CKD and HRQOL. This article reviews the recent evidence on HRQOL, its correlates and proposed intervention strategies to improve HRQOL in CKD.Recent findings-A growing body of literature indicates that various co-morbid conditions related to CKD play a substantial role in the impaired HRQOL in CKD. Hypertension, both a cause and complication of CKD, negatively affects HRQOL due to associated co-morbidities, side effects from anti-hypertensive medications and awareness of the diagnosis. Anemia has been associated with HRQOL, but concerns about the safety of erythropoietin-stimulating agents (ESA) have led to more conservative anemia treatment. Frailty, symptom burden and depression are also major contributory factors to HRQOL in CKD.Summary-Certain determinants of HRQOL in CKD, namely anemia and depression are treatable. Early identification and correction may improve overall well-being of patients. Clinical trials are required to demonstrate whether treatment interventions benefit HRQOL in this high-risk population. Furthermore, whether integration of HRQOL assessment into routine clinical practice will improve HRQOL outcomes remains to be determined.

With the increasing prevalence of hypertension, there has been a growing interest in understanding the health-related quality of life (HRQOL) of patients with hypertension. Although hypertension is often perceived as asymptomatic, it is associated with impaired HRQOL due to complications or co-morbidities, awareness of the diagnosis and adverse effects from anti-hypertensive medications. This article focuses on the literature published since 2000, on HRQOL in elderly hypertensive individuals as well as hypertensives with co-existent diseases, including chronic kidney disease (CKD), cardiovascular disease and diabetes mellitus. Most of the studies found that hypertensive individuals with co-existent co-morbidities tend to have lower HRQOL than those with hypertension alone, and identified the number of co-morbid illnesses as an independent determinant of HRQOL. The most pronounced effect was noted in the physical function domains of HRQOL. Studies have also examined the effects on HRQOL of specific classes of antihypertensive drugs without specific demonstration of superiority of 1 drug class over another in terms of HRQOL measures. While there is evidence in favor of ACE-inhibition for improving renal and cardiovascular outcomes in hypertensive patients, its role in ameliorating HRQOL outcomes remains to be established.

Background:Patients of chronic obstructive pulmonary disease (COPD) are at high risk for depression and anxiety. Yoga techniques are suited for promoting relaxation, psycho-emotional stability and exercise tolerance. Studies showing the effect of yoga in diffusion capacity are not available; hence this study was planned.Materials and Methods:The study was conducted on 60 diagnosed stable mild-to-moderate COPD patients in the age group of 30-60 years, of either sex, in the department of physiology. Patients were taken from Guru Teg Bahadur Hospital, Delhi and divided into two groups: Control and the yoga group. Both the groups were on conventional drug therapy. Subjects from the Yoga group was called to cardiopulmonary laboratory daily for 21 days and then weekly for the compliance. Yoga instructor taught them the technique of pranayama and various postures every day. They practiced yoga at home for 2 months for 45 min in the mornings. Diffusion capacity was recorded by using computerized Medisoft instrument (HYPAIR compact), in both the groups before and after 2 months.Results:Statistical analysis showed significant improvement in TLCO of the yoga group. Transfer factor of lung for carbon monoxide i.e. TLCO in mild COPD increased from 17.61 ± 4.55 to 19.08 ± 5.09 ml/mmHg/min, and in moderate COPD it increased from 14.99 ± 4.02 to17.35 ± 3.97 ml/mmHg/min.Conclusion:It was concluded that yogic breathing exercises improve diffusion capacity. They are beneficial to COPD patients and they can be used as an adjunct therapy with the conventional medical therapy.

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