CKD Management by Homeopathy (Serum creatinine can be reduced by administrating Homoeopathic medicines according to symptoms similarity. A prospective case study )
ABSTRACT
Background: Over the past few decades, chronic kidney disease (CKD) with high serum creatinine has turned into an intensive clinical and epidemiological research globally. Even though the transparency provided by the Kidney Disease Out comes Quality Initiative (KDOQI) guidelines, it appears to be within the CKD with high serum creatinine . In this situation homeopathic symptomatic treatment can play a vital role in CKD with high creatinine.
Methods: The cases of four patients with CKD and high creatinine are discussed, those who were benefited by homeopathic treatment. The more common remedies administered in the treatment of CKD with high creatinine include: Lycopodium clavatum, Apis Mellifica, Apocynum Cannabinum, Aurummuriticum, Cuprum metalicum Cantharis, Sarsaparilla, Glonoine, Serum Anguillae, Berberis Vulgaris,… etc. The patho-physiologies, diagnosis, review of CKD and serum creatinine are discussed. These case study analyses of CKD emphasize that consideration of CKD symptoms with high serum creatinine, in addition to more constitutional symptoms, is important when homeopathically analyzing these cases.
Results: The positive effects of different homeopathic medicines were clearly reducing serum creatinine during the treatment of CKD patients with hemodialysis with cost effectiveness and in the most harmless way.
Conclusions: These case study analyses found that early proper diagnosis, most appropriate selection of homeopathic remedies and follow-up is important to cure the CKD with high serum creatinine.
Keywords: Chronic kidney diseases; serum creatinine; homeopathic remedies; hemodialysis; cost effectiveness.
INTRODUCTION
Chronic kidney disease (CKD) is a general term for heterogeneous disorders affecting the kidney structure and function [1]. CKD is a worldwide public health problem. There is an increasing incidence and prevalence of patients with kidney failure requiring replacement therapy, with poor outcomes and high cost [2]. Creatinine is a chemical waste product in the blood that passes through the kidneys to be filtered and eliminated in urine. The chemical waste is a by-product of normal muscle function. The more muscle a person has, the more creatinine they produce. Levels of creatinine in the blood reflect both the amount of muscle a person has and their amount of kidney function [1].
1.1 Chronic Kidney Disease
CKD is a condition characterized by a gradual loss of kidney function over time[2] due to change of its underlying pathogenesis associated with high serum creatinine and low hemoglobin level. Although kidney disease infections are now considered less important in the western world, hypertension and diabetes are evidenced as the two major determinants of kidney disease [3]. Obesity And infections and low economic situations are also responsible.
The burden of chronic kidney disease (CKD) is studied predominantly in high-income countries, mainly in terms of prevalence, quality of life, mortality, and kidney and cardiovascular complications. Even where results of large-scale national CKDscreening programmes are available, many data sources report CKD estimates only for selected populations (limited by age group, geography, occupation,…etc),andformany countries there is no data for CKD epidemiology. The Global Burden of Diseases(GBD),Injuries, and RiskFactorsStudy is a major effort to collect and incorporate into one system all available data for 354 diseases and 84 risk factors from the published literature, registries, vital registration systems, verbal autopsies, hospital records data,… etc. GBD applies comprehensive statistical modeling to produce comparable estimates of the burden at the global, regional, and national levels [4].
1.2 Serum Creatinine
Creatinine is a waste product that comes from the normal wear and tear on the muscles of the body. Everyone has creatinine in their bloodstream[5]. Healthy Kidneys filter creatinine and other waste products from the blood. The filtered waste products leave the body through urine. Creatinine is produced from creatine. Approximately 2% of the body’s creatine is converted to creatinine every day. If Kidneys aren’t functioning properly, an increased level of creatinine may accumulate in your blood. A serum creatinine test measures the level of creatinine in your blood and provides an estimate of how well kidneys filter .A creatinine urine test can measure creatinine in urine. Most men with normal kidney function have approximately 0.6 to 1.2 milligrams/deciliters of creatinine. Women usually have lower creatinine levels than men because women on average have less muscle than men [1].
1.2.1 Fast facts on chronic kidney disease
Here are some key points about chronic kidney disease:
common symptoms include blood in urine, high blood pressure, and fatigue; causes include diabetes and specific kidney diseases, which includes polycystic kidney disease;
there is no cure for chronic kidney disease, which means treatment is focused on reducing symptoms;
diagnosis commonly occurs after blood tests, kidney scans, or biopsy [6].
1.2.2 Causes of chronic Kidney Disease
Diabetes–chronic kidney disease is linked to diabetes types 1 and 2. If the patient’s diabetes is not well controlled, excess sugar (glucose) can accumulate in the blood. Kidney disease is not common during the first 10 years of diabetes; it more commonly occurs 15-25 years after diagnosis of diabetes [6].
Hypertension (high blood pressure) – High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, including the kidneys. The narrowing reduces blood flow. If your kidneys’ blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra Fluid in the blood vessels can raise your blood pressure even more, creating dangerous cycle, and cause more damage leading to kidney failure[7].
Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers [8].
Pyelonephritis, a urinary tract infection within the kidneys, which can result in scarring as the infection heals. It can lead to kidney damage if it happens several times [9].
Kidney artery stenosis – the renal artery narrows or is blocked before it enters the kidney.
Certain toxins – including fuels, solvents (such as carbon tetrachloride), and lead (and lead-based paint, pipes, and soldering materials). Even some types of jewelry have toxins, which can lead to chronic kidney failure.
Fetal developmental problem – if the kidneys do not develop properly in the unborn baby while it is developing in the womb.
Systemic lupus erythematosus – an autoimmune disease. The body’s own immune system attacks the kidneys as though they were foreign tissue.
Malaria and yellow fever – known to cause impaired kidney function. Some medications – overuse of, for example, NSAIDs (non-steroidal anti-inflammatory drugs), and such as aspirin or ibuprofen.
Illegal substance abuse – such as heroin or cocaine.
Injury – a sharp blow or physical injury to the kidney(s) [10].
1.2.3 Clinical features of CKD
Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:
● nausea
● vomiting
● loss of appetite
● fatigue and weakness
● sleep problems
● changes in how much you urinate
● decreased mental sharpness
● muscle twitches and cramps
● swelling of feet and ankles
● persistent itching
● chest pain, if fluid build around the lining of the heart ● shortness of breath, if fluid builds up in the lungs ● high blood pressure(hypertension)that’s difficult to control [11].
Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable unable to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred
Stages of CKD
CKD is defined as either kidney damage or GFR <60 ml/min per 1.73 m2for ≥3months. Kidney damage is defined as pathologic abnormalities or markers damage, including abnormalities in blood or urine tests or imaging studies
Table1.StagesofCK
StageGFR(ml/minper1.73 m2)
| Description |
1 Kidney damage with normal or
increased GFR≥90
2 Kidney damage with mild decreased
GFR60to89
3 Moderately decreased GFR 30 to 59 4 Severely decreased GFR 15 to 29 5 Kidney failure <15r dialysis
Homeopathic Aspect
Homoeopathy treats the patient as a whole extent, in the shortest, most reliable, and most harmless way [12]. This implies that homeopathic medicine for chronic renal failure focuses on the patient as a person as well as his pathological condition. The homeopathic medicine for chronic renal failure are selected after a full
individualize examination and case analysis, which includes medical history, patient, physical and mental constitution etc. A miasmatic tendency is also often taken into account for the treatment of chronic renal failure [13,14]. Homeopathy carrying the holistic concept doesn’t recognize renal failure as merely a disease related to the kidney alone but always consider something prior to this sickness that is to say the morbid affection of life / vital force, the suffering of the dynamic; or the life principle of the organism due to which individual as whole suffers. His suffering is made known to us through different perceptible sign and symptoms (characteristic symptom) which constitute not only the soul guide to the choice of the curative remedy, but also sometimes, it is very difficult to find individual single remedy which can cover the totality, due to paucity of characteristic symptoms or due to severe suppression of the disease or due to advanced pathological changes in the body. Hence, in this situation, one has prescribe a medicine based on the present signs and symptoms and this is the condition where rare homeopathic medicine has its important role to play which
[15].clears the pictures of disease and provides fastest possible recovery 1.3.1 Miasmatic interpretation of chronic kidney disease Kidney develops from within the intermediate mesoderm, early nephrons develop from induction of primary mesenchymal cells. It is the most highly differentiated organ in the body. The kidneys are important for maintaining the body’s internal balance, especially of water and minerals (sodium, potassium, chloride, phosphate, magnesium, sulfate,..etc.); acid base balance and removal of fuel or drug metabolites[22]. The kidneys also function as a part of the endocrine system and produce erythropoietin and calcitriol, thrombopoietin, renin and prostaglandins performing hematopoietic function, regulation of blood calcium level; regulation of
blood pressure by regulating the volume of extracellular fluid and through renin- angiotensin mechanism [23].
Chronic kidney disease is defined as an abnormality of kidney structure or function for≥3 months. The most common causes of CKD are diabetes mellitus, hypertension and glomerulonephritis.
Considering the end stage renal disease, it is essentially syco-syphilitic innatureowing to the nature of the symptoms. However the developmental stages of renal failure involve different pathological changes and these changes will decide the[18].
miasmatic preponderance at that stage
§ 78
The true natural chronic diseases are those that arise from a chronic miasm, which when left to themselves, and unchecked by the employment of those remedies that are specific for them, always go on increasing and growing worse, notwithstanding the best mental and corporeal regimen, and torment the patient to
the end of his life with ever aggravated sufferings.
These are the most numerous and greatest scourges of the human race; for the most robust constitution, the best regulated mode of living and the most vigorous energy of the vital force are insufficient for their eradication.
Depending upon the cause These mostly cover Sycotic & sometimes Syphilitic Miasm in background.
METHODOLOGY
1.3 Study aim
The overall aim of this study was to determine the practice patterns for CKD with high serum creatinine and low hemoglobin patients by homeopathic symptomatic remedies without hemodialysis. This information should inform future service development and the design of a future prospective research study to evaluate the effectiveness, cost-effectiveness and appropriateness of chronic kidney management compared with hemodialysis for treating CKD with high serum creatinine patients. To make it clear that a chronic kidney patient can have a normal life with low cost by homeopathic treatment without any hemodialysis. 1.4 Methods
The case study of four patients with CKD and high creatinine from our observations are discussed, those who were benefited by homeopathic treatment. The more common remedies administered in the treatment of CKDwithhigh creatinine include:
Lycopodium Clavatum, Apis Mellifica, Apocynum Cannabinum, AurumMuriticum, Cantharis, Sarsaparilla, Glonoine, Serum Anguillae, Berberis Vulgaris,…etc. Thepatho-physiologies, diagnosis, review of CKD and serum creatinine are discussed. These case study analyses of CKD emphasize that a consideration of CKDsymptoms with high serum creatinine, in addition to more constitutional symptoms, is important when homeopathically analyzing these cases.
2. PRESENTATION OF CASES
Case Study-1
A 57 years old person presented on June 20, 2017 with complaints of generalized swelling more on both legs and face for 7 months. The patient was too much weak and prostrated. He was also having breathing difficulty and someblack
pigmentation was also present here and there. Patient was hypertensive and used to take modern medicine. All the complaints had started after liver complaints. Patient had no significant past history other than rheumatoid arthritis and family history was also not significant. His upper lip was cracked. His tongue was brown coated. Appetite was diminished with early satiety and empty stomach constant eructation, nausea, frequent vomiting, used to take a little water from time to time. Lower Abdomen was distended with loud flatulence and gurgling, it was difficult to pass the gas. (21 ) .On Jun 6, 2017 his serum creatinine was 14.20 mg/dl. According to law of symptom similarity of homeopathy, without hemodialysis, the patient was treated by symptomatic homeopathic remedy lycopodium and then almost one month later, on July 8, 2017 his serum creatinine fall down 2.50mg/dl and on April 3, 2018 his serum creatinine had fall down 1.50 mg/dl. Lycopodium was repeated as needed for 6 months and considerable relief in symptoms and investigation reports were the outcome.
2.1 Case Study-2
The case study begins with a 26 years old male, presented with a history of generalized weakness, nausea, reduced appetite and reduced urine output for two months. He had Sleep problems screaming in sleep, mental anxiety, muscle twitches and cramps, edema of the lower lids, Swelling of feet and ankles, scanty urination Persistent itching, chest pain, shortness of breath, H/o high blood pressure (hypertension) that’s difficult to control from 3 years back. He had low back pain for a long time that’s controlled by analgesics. Family history was non diabetic and non hypertensive. His initial serum creatinine was 3.3 mg/dl on February 2, 2020 and it had come down to 2.1 mg/dl on August, 2020. According
to law of symptom similarity of homeopathy, the patient was treated by homeopathic remedy (21)
Apis mellifica 200 was indicated thrice a day for a week and then repeated if necessary. The patient had a remarkable change of serum creatinine and has been leading a comparatively better life without hemodialysis from the starting period of treatment to till date.
2.2 Case Study-3
A 63 years old elderly patient came to the clinic on April 4, 2017, who had chronic parenchymal renal disease, HTN with high serum creatinine and low hemoglobin for which he was treated conventional treatment with hemodialysis, but the problems of this patient were gradually become serious and that time he was also suffering from severe dyspnoea, puffiness of the face and pitting leg edema and other CKDsymptoms.
On March 29, 2017 his serum creatinine was 11.5 mg/d. According to law symptom
similarity of homeopathy, this patient was treated by homeopathic remedy Elserumwhich was given in 30 and repeated as needed there was a nice change in renal function.without hemodialysis, and then almost 7 months later, on October15, 2017his serum creatinine had come down 5.56 mg/dl and on November 5, 2017 is serum creatinine had come down 2.9 mg/dl.
2.3 Case Study-4
On December 23, 2018, a 61 year old was diagnosed with CKD . He had developed hypertension several years earlier and was being treated with conventional medicine. The heart rate was 64/min, while the blood pressure was 146/90 mm Hg. His parents, grandparents, and my brother had no kidney disease and heart disease. The patient was 164 cm tall and weighed 68 kg. H/o malarial fevers recurrent There was slight pitting edema in both legs and face. On December 24, 2018 the patient was being done serum creatinine by our advice. Laboratory report revealed a serum creatinine of 7.78 mg/dl. Next day patient came and was examined thoroughly both physically and mentally. his case taking according to law of homeopathic symptoms similarity was taken. confirmed and noticed that patient was CKD with hypertensive. At that time, throbbing chest, anorexia, Nausea and vomiting, general weakness belonged to the patient. According to law of symptom similarity of homeopathy, the patient was treated by symptomatic (21)
homeopathic remedy Apocynum and on January 2, 2019 his serum creatinine fall down 7.1 mg/dl and on September 25, 2020 his serum creatinine had fall down 4.92 mg/dl. Though there is no remarkable change of serum creatinine but patient has been leading better life without hemodialysis from the starting period of treatment to till date.
3. Results
The outcomes of these case studies clearly show the efficacy of the homeopathic drugs in CKD with high serum creatinine .The positive effects of different homeopathic medicines were clear in reducing serum creatinine during the treatment of CKD patients without hemodialysis with cost effectiveness and harmless way.
4. DISCUSSION
On World Health Day, latest studies show a ray of hope for patients of kidney failure and hypothyroidism through Homeopathy. According to the latest study, a positive impact has been noticed of homeopathy treatment on a significant percentage of patients of kidney failure and hypothyroidism. The chronic kidney disease study analyzed the records of 61 patients across two non-continuous months in 2018 and 2019. It found that by the third visit to the clinic, 50-58.3 percent patients demonstrated an improvement in their serum urea and creatinine readings. “In Chronic kidney disease study, we found that two of the most clinically important readings in patients showed improvement. No currently available treatment is able to effect a reduction in serum urea and creatinine readings. This may turnout to be of immense benefit to patients. Since these readings are a part of the decision- making process of whether to start dialysis or not, homeopathic treatment may help patients avoid the start of dialysis” said Dr Kalyan Banerjee, who was instrumental behind the study [20]. In this study, we only showed that serum creatinine was reduced gradually by selective homeopathic remedies which were selected according to the law of symptom similarity. Homeopathic medicines along with conventional treatment not only repair the damaged kidneys but side by side it helps in maintaining the normal blood sugar level and blood pressure [19].
5. CONCLUSIONS
The homeopathic management of CKD is done with the artistic use of law of law of law of similarity. These case study analyses found that early proper diagnosis, most appropriate selection of homeopathic remedies and follow-up is important to cure the CKD with high serum creatinine and possible resulting renal failure can be dreadful. The advanced pathological condition like renal failure can be handled by use of small remedies with marvelous output. Even the constitutional remedies are also much helpful when one considers the miasmatic background. Unfortunately, the reportorial use one should not forget to get the similimum for the pathological cases like CKD.
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