Abstruct-Renal calculi, commonly known as kidney stones, are a significant source of pain and morbidity. Homeopathy offers an alternative approach to managing these stones, focusing on individualized treatment and natural remedies. Key homeopathic medicines like Berberis vulgaris, Lycopodium, and Sarsaparilla are frequently used to alleviate symptoms, promote stone expulsion, and prevent recurrence. Although anecdotal evidence and case studies suggest potential benefits, including pain relief and reduced stone formation, rigorous scientific validation is still needed. This abstract highlights the potential of homeopathy as a complementary therapy in the holistic management of renal calculi
Keyword– Renal calculi, stones, nephrolithiasis, flank pain.
Introduction – Living with recurring episodes of excruciating pain & requiring surgery every 5 to 10 years are incidents that people with kidney stones go through. Such people go through chronic inflammations in the body that can lead to life threatening infections & Urinary Tract Infections (UTI). Stones or calculi develop in the kidneys when substances like calcium oxalate, uric acid, struvite crystallize due to high concentration in urine. Such crystals can then aggregate to form stones of various sizes thus causing blockages & blockage in the excretory system.
Epidemiology: Kidney stones are a widespread issue that affects people all over the world. The renal stone disease belt in India spans across Maharashtra, Gujarat, Rajasthan, Punjab, Haryana, Delhi, Madhya Pradesh, Bihar, and West Bengal states . The annual prevalence is estimated to be around 3-5%, and the lifetime prevalence is approximately 15-25%. After the first occurrence, the chance of recurrence within the first year is 14%, within the fifth year is 35%, and within the tenth year is 52%.
Predisposing factors for kidney stones
Environmental and dietary causes
- Low urine volumes: high ambient temperatures, low fluid intake
- Diet: high protein, high sodium, low calcium
- High sodium excretion
- High oxalate excretion
- High urate excretion
- Low citrate excretion
Acquired causes
- Hypercalcaemia of any cause
- Ileal disease or resection (increases oxalate absorption and urinary
excretion)
- Renal tubular acidosis type I
Congenital and inherited causes
- Familial hypercalciuria
- Medullary sponge kidney
- Cystinuria
- Renal tubular acidosis type I (distal)
- Primary hyperoxaluria
Pathogenesis
In the consideration of the processes involved in crystal formation, it is helpful to view urine as a complex solution. A clinically useful concept is supersaturation (the point at which the concentration product exceeds the solubility product). However, even though the urine in most individuals is supersaturated with respect to one or more types of crystals, the presence of inhibitors of crystallization prevents the majority of the population from continuously forming stones. The most clinically important inhibitor of calcium-containing stones is urine citrate.
Types of Renal Calculus
- Calcium Stone – calcium stones are the most common comprising about 75% of all urinary calculi. The may be pure stone of calcium oxalate 50% or calcium phosphate 5%, or mixture of calcium oxalate and calcium phosphate 45%. About 50% of patients with calcium stone have idiopathic hypercalciuria without hypercalcaemia. The mechanism of calcium stone formation is explained on the basis of the imbalance between the degree of supersaturation of the irons forming the stone and the concentration of inhibitors in the urine.
- Mixed ( struvite) stones – About 15% of urinary calculi are made of magnesium- ammonium-calcium phosphate, often called struvite; hence mixed stones are also called ‘struvite stone’ or ‘triple phosphate stones’. Struvite stones are formed as a result of infection of the urinary tract with urea-splitting organisms that produce urease such as by species of proteus, and occasionally klebsiella, pseudomonas and Enterobacter. These are, therefore, also known as infection- induce stones. Staghorn stone’ which is a large , solitary stone that takes the shape of the renal pelvis.
- Uric acid stones- Approximately 6% of urinary calculi are made of uric acid. Uric acid calculi are radiolucent unlike radio- opaque calcium stones. Uric acid stones are frequently formed in cases with hyperuricaemia and hyperuricosuria such as due to primary gout or secondary gout due to myeloproliferative disorders. Especially those on chemotherapy, and administration of uricosuria drugs ( e. g. salicylates, probenecid).
- Cystine stones- cystine stones are associated with cystinuria due to a genetically determined defect in the transport of cystine and other amino acids across the cell membrane of the renal tubules and the small intestinal mucosa.
Clinical Features
- The patient is suddenly aware of pain in the loin, which radiates round the flank to the groin and often into the testis or labium, in the sensory distribution of the first lumbar nerve.
- The patient is restless and generally tries unsuccessfully to obtain relief by changing position or pacing the room.
- There is pallor, sweating and often vomiting.
- Frequency, dysuria and haematuria may occur.
Investigation – In serum WBC increase
Urine -RBS & WBC, CRYSTAL
Urine -culture routine and microscopy
Radiography
Helical computed tomography
Physical examination – weight ,bp, costovertebral angle tenderness & lower extremities edema as well as other systemic conditions such as primary hyperparathyroidism & gout .
History of patient– UTI , gastric bypass surgery , malabsorptive condition , gout , HTN, DM, dietary habits.
Management
- Conservative measures.
• Percutaneous methods: Percutaneous nephrolithotomy.
• Extracorporeal Shock Wave Lithotripsy.
• Surgical methods
• Open surgery:
a. Pyelolithotomy
b. Partial nephrectomy
c. Nephrectomy.
d. Nephrolithotomy.
Homoeopathic Medicines –
Berberis vulgaris – Urine with thick mucus and bright-red, mealy sediment. Bubbling, sore sensation in kidneys. Pain in the thighs and loin on urinating.
Calcarean carbonica – Dark, brown, sour, fetid , abundant , with white sediment, bloody.
Colchicum autumnale – Urine; dark , scanty or suppressed; in drops, with white sediment; bloody, brown, black , inky; contains clots of putrid decomposed blood, albumin, sugar
Equisetum hyemale- Deep pain in region of right kidney, extending to lower abdomen , with urgent desire to micturate. The right lumber region is painful.
Lycopodium clavatum – Red sand in urine , on child’s diaper ‘ pain in back, relieved by urinating ; renal colic, right side.
Sarsaparilla – Neuralgia or renal colic; excruciating pains from right kidney downwards.
Passage of gravel or small calculi; renal colic; stone in bladder; bloody urine.
Phosphorus – Turbid, brown , with red sediment.
Pareira brava– Black, bloody, thick mucoid urine. Constant urging; great straining; pain down thighs while making efforts to micturate. Can emit urine only when he goes on his knees, pressing the head firmly against the floor.
Authors ;
Dr. Hansa Iske – MD Scholar, Dept. of practice of medicine , Govt . Homoeopathic Medical college & Hospital, Bhopal , MP
Under the guidance of;
Dr. Praveen Jaiswal – Head of the department Dept. of practice of medicine , Govt. homoeopathic medical college & Hospital , Bhopal, MP
