Interview with Dr Vasilije Tomanoski from Nefroplus, Ohrid, Republic of North Macedonia

BACKGROUND: Chronic kidney disease (CKD) is a progressive condition associated with severe physical, psychological, and social consequences, particularly in patients requiring long-term hemodialysis. Alongside conventional nephrological care, there is growing interest in complementary rehabilitation approaches aimed at improving quality of life. AIM: To present the historical development of the Dialysis Center in Struga, outline the clinical challenges of CKD and hemodialysis, and evaluate the role and effects of yoga as a complementary method in the rehabilitation of patients with chronic kidney insufficiency by the interview with Dr Vasilije Tomanovski from the Nefroplus, Ohrid, Republic of North Macedonia. METHODS: This work is based on a descriptive and experiential analysis of clinical practice at the Dialysis Center in Struga, combined with observations from a seven-month pilot yoga therapy program involving patients with end-stage CKD undergoing hemodialysis. Data were derived from clinical experience, patient-reported outcomes, and professional observations, and were further discussed in scientific and international forums. RESULTS: Hemodialysis significantly prolonged survival and improved metabolic stability but was associated with physical, neurological, and psychological complications. The yoga therapy program was well accepted by both patients and medical staff and led to improvements in dialysis tolerance, physical endurance, mood, sleep quality, social interaction, and adherence to dietary and hygiene regimens. In some patients, profound psychosocial and functional improvements were observed. CONCLUSIONS: The Dialysis Center in Struga emerged as a leading institution in the former Yugoslavia due to strong professional dedication and team spirit. CKD patients face complex physical and psychological burdens that are only partially addressed by hemodialysis. The integration of yoga as a complementary rehabilitation method was well accepted by both patients and medical staff and was associated with notable improvements in physical endurance, psychological well-being, social interaction, and tolerance to dialysis. These findings support the holistic integration of complementary therapies into conventional care and justify further controlled and long-term research on yoga therapy in CKD rehabilitation.