Tag: Chronic Kidney Disease

ABSTRACT

A healthy human body consists of two kidneys that filter your blood. Each of our kidneys consists of millions of nephrons which removes toxins and excessive fluid from the blood. The most common wastes are ammonia, urea (nitrogen waste), creatinine (muscle waste), excessive amounts of salts etc. which are then excreted out in urine. A nephron consists of glomerulus, Bowman’s capsule (here blood gets filtered) and tubules (where extra water and ions are reabsorbed by body if required). A healthy kidney filters about 1100-1200 ml/min of blood to generate about 125ml/min of filtrate in Bowman’s capsule. When the renal filtration rate falls and the kidneys are unable to filter out the metabolic waste from the body the chronic kidney disease develops. Let’s discuss!!

INTRODUCTION

Chronic Kidney Disease (CKD) is a condition where the kidneys gradually lose their ability to function efficiently. This damage happens slowly, often over many years, and it can lead to serious life-threatening complications if left untreated. Early stages may have no symptoms, but as the disease progresses, people experience fatigue, Pedal edema, High blood pressure, and trouble in urination. Major risk factors are diabetes, Hypertension, Obesity and Certain infections. If left untreated, CKD can eventually lead to kidney failure, where dialysis or a kidney transplant may be needed. Regular check-ups can help detect CKD early and slow its progress.

CAUSES

Major two causes of CKD are:

1. Diabetes Mellitus: Patients with prolonged history of diabetes often land in CKD as a result of poorly managed blood sugar levels. The first sign of diabetes affecting kidneys is protein in urine. The healthy kidneys will not filter out albumin as it is essential for the body. But when renal damage begins, the patient loses protein through urine. As a result, patients will lose weight.
2. Hypertension: In patients with prolonged history of increased hypertension, it can damage the blood vessels in your kidneys, making it difficult for them to remove toxins and extra fluid from your body. This extra fluid can raise your blood pressure even more, causing a hopeless cycle. Taking care of your blood pressure can help protect your kidneys and break this cycle.

Other causes include:

• Certain infections like untreated & long-lasting UTIs, sepsis
• Congenital conditions like hydronephrosis, renal and urinary tract abnormalities
• Polycystic kidney disease
• Drug toxicity
• Heavy metal poisoning like lead poisoning
• Glomerulonephritis, IgA nephropathy
• Renal artery stenosis
• Systemic lupus erythematosus: this disease affects whole body but when it affects kidneys it is called lupus nephritis
• Hemolytic uremic syndrome (HUS)
• Renal stones

SYMPTOMS

CKD doesn’t produce any early symptoms, but if they are present, they may include:

• Foamy urine
• Urinating (peeing) more often or less often than usual
• Itchy / dry skin
• Feeling tired
• Nausea
• Loss of appetite
• Weight loss without trying to lose weight (due to proteinuria)

Advanced CKD symptoms are seen as:

• Shortness of breath
• Pedal edema or edema in legs, arms, ankles
• Puffy eyes
• Trouble sleeping
• Anemia
• Muscle cramps
• Ammonia breath (urine-like or “fishy” breath)
• Skin darkening
• Numbness
• Ascites

STAGES OF CHRONIC KIDNEY DISEASE

• Stage 1: Kidney damage with normal or increased GFR (> 90 mL/min)
• Stage 2: Mild reduction in GFR (60-89 mL/min)
• Stage 3a: Moderate reduction in GFR (45-59 mL/min)
• Stage 3b: Moderate reduction in GFR (30-44 mL/min)
• Stage 4: Severe reduction in GFR (15-29 mL/min)
• Stage 5: This is diagnosed as End-stage kidney disease (GFR < 15 mL/min).

DIAGNOSIS

1. Blood Tests: KFT is a key diagnostic test in CKD to determine the creatinine levels in the body. On the basis of creatinine levels along with your age, size, gender; your eGFR levels are calculated. For males, the creatinine levels should be 0.7 mg/dL to 1.3 mg/dL and for females, it should be 0.6 mg/dL to 1.1 mg/dL.
2. A/G Ratio Test: The albumin & globulin are two essential proteins in the body. Their higher ratio indicates protein loss through urine and progression of CKD.
3. ABG Analysis: for monitoring blood electrolyte levels.
4. Urine Analysis: Physical examination of urine is done to check for pus cells.
5. IMAGING examinations: USG, CT SCAN can be done to study the damage done to renal parenchyma.

TREATMENT

Since it is a progressive disease, only symptomatic treatment can be given to manage it.

1. Oral glycemic drugs or insulin therapy can be given to regulate blood sugar levels.
2. Antihypertensives which are renal safe can be given for BP regulation.
3. Sodium bicarbonate to deal with acidosis.
4. Once creatinine levels are >3 mg/dL, dialysis is advised. The frequency of dialysis will depend on the health of kidneys.
5. After a certain time, when dialysis cannot be carried forward and kidneys are failing, then renal transplant is the only option.

To not land in this situation, timely intervention and disease management is essential to stop the ongoing renal damage. With the help of Ayurveda and timely intervention, the damage done to the kidneys can be stopped. Mind it, the damage once done to the kidneys is not at all reversible but its progression can be stopped. With the help of Ayurveda, the frequency of dialysis in many patients can be decreased and the progression towards renal failure can be stopped.

AYURVEDIC OVERVIEW

In Ayurveda, we can correlate CKD with “Mutrakricha” i.e., retention of urine. Acharya Charaka (Ancient Vaidya of medicine) has explained about 8 types of mutra-kricha.

Among the many nidanas (causes); ativyayama (overexertion), teekshna aushad (strong medications), rooksha Madhya (drying variety of alcohol like gin, vodka), Anupa matsya (Kapha dominated non-veg food), Adhyashana (consuming food before the digestion of previous meal), Ajeerna (Indigestion).

This disease manifests due to the above-mentioned nidanas (causes) causing the production of Ama (toxin buildup in the stomach) in the body which leads to “stroto-avrodh” (obstruction) which causes Vata dosha to get vitiated. If this vitiated vata causes kha-vaigunyata in the basti (urinary bladder) it may result in acute or chronic kidney disease.

Acharya Charaka has mentioned that foamy urine and edema is due to vitiated kapha dosha. Since the imbalance of doshas is causing kha-vaigunyata of the basti marma, uttarbasti (oil-based enema given through the ureter) can be given to achieve the equilibrium in basti marma.

AYURVEDIC HERBS BENEFICIAL IN CKD

• Varuna: The extract from the bark of the varuna which is enriched with alkaloids like rutin, quercetin and varunol is known for its diuretic and lithotriptic properties. Varun chhal (bark) is used for lowering creatinine levels. It does this by increasing your urine output, which helps in lowering the creatinine levels. Varuna helps in balancing vitiated kapha and vata doshas due to its Ushna veerya (hot potency), tikta rasa (bitter) and kashaya rasa (astringent properties).
• Punarnava: It is a potent diuretic and anti-inflammatory with Tikta rasa (bitter), kashaya rasa (astringent). The whole plant is used from its roots to the flower, but the extracts from roots are most potent. The leaves from punarnava are consumed as a vegetable to reduce edema. Its anti-diuretic effect helps in decreasing water retention in the body and retaining the electrolyte balance. It is an excellent blood purifier and also helpful in increasing Hb count.
• Gokshura Gokshura is a potent mutual (diuretic) herb. It is tridosha shamak (balances all three doshas) but since it is rich in madhur rasa (sweet) and is of sheet veerya (cool potency) it works on vitiated pitta dosha. Also known as trikantaka, this herb is pramehhara i.e. it is helpful in reducing blood sugar levels. Thus, helpful in chronic kidney disease.
• Palash: This plant is commonly known as flame tree. It is helpful in reducing inflammation and eliminating toxins, thus improving kidney function. As a result, it is useful in treating chronic kidney failure and uremia. It is both kapha and pitta dosha shamak as the bark of the plant is of Ushna veerya (hot potency) and root is sheet in veerya (cool potency). The flowers of Palaash improve kidney function, reduce inflammation & improves the elimination of toxins. It also assists in the drainage of excess uric acid from the blood.

HERBAL REMEDIES FOR CHRONIC KIDNEY DISEASE BY PLANET AYURVEDA

Planet Ayurveda provides a combination of above-mentioned ayurvedic herbs for the management of chronic kidney disease. With the use of above-mentioned herbs, Planet Ayurveda has compiled the “Revive Kidneys Pack”. This pack includes Mutrakrichantak churna, Rencure formula, Varunadi vati, Punaranava Mandur, and Chandanadi vati. All the Planet Ayurveda medicines are 100% natural, vegetarian, additive-free, chemical & preservative-free, and without any side effects.

PRODUCT DESCRIPTION

1. MUTRAKRICHANTAK CHURNA

This churna is prepared using standardized extract from varuna (Crataeva nurvala), bhumi-amlaki (Phyllanthus niruri), gokshur (Tribulus terrestris), and Kalmegh (Andrographis paniculata). It can balance out all the tridoshas. Since these herbs have a mutual (diuretic) effect, it helps in lowering the raised creatinine levels and thus improves glomerular filtration of blood in kidneys. It has also proven to reduce burning moisture.

Dosage: Since it is available in churna form, 1 teaspoonful with water is recommended for the best results. Boil 1 teaspoonful in 400ml water until it remains 50-60ml. Filter the preparation with a regular tea strainer and drink. You should use this twice a day, 45 min. after breakfast and 45 min. after dinner. Prepare fresh every time.

2. RENCURE FORMULA

It is available in capsule form. It contains ayurvedic herbs such as Punarnava (Boerhavia diffusa), Varun (Crateava nurvula), Gokshur (Tribulus terrestris), Palaash (Butea monosperma), and Kasni (Cichorium intybus). The aqueous extract of Kaasni is efficient in lowering serum creatinine and serum urea levels. The diuretic properties help to remove the toxins from the body.

Dosage: 1-2 Capsules twice daily, with plain water, after meals.

3. VARUNADI VATI

Varunadi vati is available in tablet form which is prepared using the standardized extract from varuna (Crataeva nurvala), punarnava (Boerhavia diffusa), Gokshur (Tribulus terrestris), and shuddha Guggulu (Commiphora mukul). The extract quercetin from varuna and punarnava helps in repairing the renal damage caused by heavy metal toxicities. It is also helpful in decreasing water retention, thus reducing edema.

Dosage: 1-2 tablets twice or thrice daily with lukewarm water.

4. PUNARNAVA MANDUR

It is a classical medicine available in capsule form, prepared from the standardized extract of punarnava and loh bhasma (Iron ash) after following proper purification methods. It is helpful in correcting iron deficiency anemia, blood purification, etc. It reduces water retention in the body due to its Shothahara (Anti Inflammatory) properties, thus also indicated to use in ascites. Since the CKD patients suffer from low levels of Hb in advanced conditions, it is recommended for them.

Dosage: 1-2 tablets twice or thrice daily with lukewarm water.

5. CHANDANADI VATI

Chandanadi vati is available in tablet form and is prepared using standardized extract of Chandan (Santalum album), elaychi (Ellectaria cardamom), kabab-chini (Piper cubeba), amlaki (Phyllanthus emblica), and similar herbs. It is helpful in removing excessive kapha dosha, aama (toxins) from the body. Amlaki in it helps in balancing tridoshas as it cleanses the bladder and relieves the burning sensation. Chandan balances excess heat due to its sheet veerya (cool potency). Ela reduces inflammation and kabab-chini is known for its anti-microbial properties.

Dosage: 1-2 tablets twice or thrice daily with lukewarm water.

CONCLUSION

Chronic Kidney Disease is a slow progressive disease characterized by gradual loss of kidney function. Early detection and proper management are crucial in slowing the progression and reducing complications. Key factors contributing to CKD include hypertension, diabetes, and genetic predispositions, among others but effective management involves controlling underlying health conditions, adopting a healthy lifestyle, and medical interventions such as medications or dialysis. The modern biomedicine gives minimal importance to the factors of causation and is more oriented in treating the presenting features or as you say symptoms. The etiology at times may have a decisive role in the management of CKD especially in cases where the patient is treated from one side but continues with etiological factors as said in Ayurveda “nidansevan”. Therefore, to manage the CKD “Nidan-parivarjan” is essential which means cessation of etiological factors. It is essential to address the disease early to prevent further complications, such as kidney failure. Regular monitoring, patient education, and a collaborative approach between healthcare providers and patients are fundamental in managing CKD effectively.