<![CDATA[Chronic kidney disease is a critical global healthcare challenge frequently exacerbated by psychological distress. Non-pharmacological interventions targeting both psychological and physiological pathways remain poorly understood. Objective: This study evaluated the effects of combining dhikr with deep breathing exercise on stress, anxiety, and cortisol level among chronic kidney disease patients. A randomised controlled trial was conducted at Syarifah Ambami Rato Ebhu Hospital, Bangkalan, involving 34 hospitalised patients equally allocated to an intervention programme (n = 17) or a standard health education control group (n = 17). Data were analysed using the paired t-test, independent t-test, and multivariate analysis of variance. The combined intervention significantly decreased post-test stress (p = 0.001) and anxiety (p = 0.021) relative to the control cohort. Changes in serum cortisol concentration were not statistically significant within or between groups (p = 0.864). However, the omnibus multivariate analysis demonstrated a highly significant concurrent effect across all tracked parameters (p < 0.001). Integrating dhikr with deep breathing exercise effectively minimises psychological distress in individuals with chronic kidney disease, providing a viable non-pharmacological complementary modality.]]>
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