Homoeopathic Approach in Cases Of Chronic Renal Failure

Abstract:

Homoeopathy does not recognise kidneys as a mere organ of excretion or selective filtration but always recognises it in relation to an individual as a whole. Kidneys have generalised function, the fluids coming to it and going from it influence every organ, tissue, and cell of the body. Kidney function influences the complete vital economy of our body. When there is disturbance in harmony occur this normal function disturbance and produce various diseases and produces disturbance at mental level. The state of patient with chronic renal failure or end-stage kidney disease is very pathetic not only for patient himself but also for family and society. Homoeopathic treatment can help to improve patient’s quality of life through relief of troublesome symptom, limit renal damage, and preserve existing renal functioning as well as prevent complications.

Keywords:

Chronic renal failure, homoeopathy, dialysis, end stage kidney disease, fluid, and electrolytes.

Abbreviations:

HIV: human immuno virus, CKD: chronic kidney disease.

Introduction:

The major function of kidney is to remove waste products and excess fluid from body through urine. It also maintain overall fluid balance. Also, regulating and filtering minerals from blood. When there is disturbance occurs in the harmony due to any causes various disease occurs. One of dangerous diasease is chronic renal disease. The term “chronic renal disease” means lasting damage to the kidneys that can get worse over time. If the damage is very bad, then kidney may stop working. This is called kidney failure or end stage renal disease. If kidney fails, it need dialysis or a kidney transplant in order to live. Chronic renal failure is progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolism, fliud and electrolyte balance fails resulting in uraemia.^[1,2]

Causes of chronic renal failure ^{[ 3,4,5]}

Primary glomerular disease

• Focal and segmental glomerulonephritis
• Membranoproliferative glomerulonephritis
• Immunoglobulin A nephropathy
• Membranous nephropathy
• Secondary glomerular disease
• Diabetic nephropathy
• Amylodosis
• Post infectious nephropathy
• HIV-associated nephropathy
• Collagen-vascular disease
• Sickle cell nephropathy
• HIV-associated membranoproliferative glomerulonephritis
• Tubulointestitial nephritis
• Drug hypersensitivity
• Heavy metals
• Analgesic nephropathy
• Reflux/ chronic pylonephritis
• Idiopathic

Obstructive nephropathies such as

• Prostatic disease
• Nephrolithiasis
• Retroperitoneal fibrosis/tumour
•  

Hereditary disease

• Polycystic kidney disease
• Medullar cystic disease
• Alportis syndrome

(Figure-1) ^[6]

Clinical presentation of chronic renal failure^[5]

Initial symptoms may include the following:

• Fatigue
• Frequent hiccups
• General ill feeling
• Generalised itching (pruritus)
• Headache
• Nausea, vomiting
• Unintentional weight loss.
• Loss of appetite.
• Increased frequency of urination.
• Excessive urination at night
• Swelling of face.

Later symptoms may include the following:

• Blood in the vomit or in stools
• Decreased alertness, including drowsiness,confusion, delirium, or coma.
• Decreased sensation in the hands, feet, or other areas
• Easy bruising or bleeding
• Increased or decreased urine output
• Muscle twitching or cramps
• Seizures
• White crystals in and on the skin (uraemic frost).
• Hallucinations.
• Stupor.

Additional symptoms that may be associated with this disease:

• Abnormally dark or light skin
• Agitation or irritability.
• Breath odour
• Excessive thirst
• High blood pressure
• Loss of appetite
• Nail abnormalities
• Paleness
• Diarrhoea.
• Oliguria.
• Difficulty in breathing.
• Pain in chest.
• Cramps.
• Bone pains.
• Bruises.
• Epistaxis.

Complications of chronic renal failure^[5]

• Anaemia
• Decreased immune response
• Decreased libido, impotence
• Haemorrhage from any orifice
• High blood pressure
• Increased risk of infections
• Joint disorders
• Liver inflammation (hepatitis B or hepatitis C)
• Liver failure
• Loss of blood from the gastrointestinal tract
• Menstrual irregularities, miscarriage, infertility
• Ulcers
• Seizures
• Weakening of the bones causes fractures

Diagnosis of chronic renal failure^[5]

Chronic kidney disease is identified by a blood test for serum creatinine. Higher levels of serum creatinine indicate a falling glomerular filtration rate (rate at which the kidneys filter blood) and as a result a decreased capability of the kidneys to excrete waste products. Creatinine levels may be normal in the early stages of CKD, and the condition is discovered if urine analysis (testing of a urine sample) shows that the kidney is allowing the loss of protein or red blood cells into the urine.

To fully investigate the underlying cause of kidney damage, various forms of medical imaging, blood tests and often renal biopsy (removing a small sample of kidney tissue) are employed to find out if there is a reversible cause for the kidney malfunction.

General management of chronic renal failure^[3,4]

• Fluid restriction according to urine output.
• Maintain electrolyte balance.
• Control of blood pressure
• Correction of anaemia (anaemia of renal failure does not respond to any therapy).
• Dialysis and kidney transplantation, if general and medical management fails.
• Protein restriction to 0.5gm/kg body weight.

Homoeopathic aspect:

Homoeopathy treats the person as a whole. This implies that homoeopathic medicine for

chronic renal failure focuses on patient as a person as well as his pathological

condition. The homoeopathic medicine for chronic renal failure are selected after a full

individualise examination and case analysis, which includes medical history of patient,

 physical and mental constitution, etc. a maismatic tendency is also often taken into

account for the treatment of chronic renal failure.^[2,7]

Commonly indicated homoeopathic remedies ^[5,8]

• Aconitum napellus
• Allium cepa
• Apis mellifica
• Argentum nitricum
• Arnica montana
• Arsenicum album
• Aurum metallicum
• Belladonna
• Benzoicum acidum
• Berberis valgaris
• Bryonia alba
• Cannabis indica
• Cannabis sativa
• Cantharis
• Chelidonium majus
• Crotalus horridus
• Eupatorium purpureum.
• Helleborus niger
• Helonias dioica.
• Hepar sulphuricum
• Kalium chloratum
• Lachesis mutus
• Laurocerasus
• Lycopodium clavatum
• Mercurius corrisivus
• Natrum muraticum
• Nux vomica
• Phosphorus
• Rhus toxicodendron
• Sabina
• Sarsaparilla
• Senecio aureus
• Silicea terra
• Stramonium
• Streptococcinum
• Sulphur
• Terebinthiniae oleum

Aconitum napellus

• Urine: scanty, red, hot, painful.
• Tenesmus and burning at neck of bladder.
• Burning in urethra.
• Urine suppressed, bloody.
• Anxiety always on beginning to urinate.
• Retention, with screaming and restlessness, and handling of genitals.
• Renal region sensitive.
• Profuse urination, with profuse perspiration and diarrhoea.

Allium cepa

• Pains in renal region, and region of bladder very sensitive.
• Sensation of weakness in bladder and urethra.
• Increased secretion of urine with coryza.
• Urine red with much pressure and burning in urethra.
• Pain in kidney region, more left side. Urine frothy and iridescent. Red.

Apis mellifica

• Homoeopathic medicine for chronic renal failure having swelling or puffing up of various parts, oedema, red rosy hue, stinging pains, soreness, intolerance of heat, and slightest touch, and afternoon aggravation are some of the general guiding symptoms.
• Generalised swelling, acute inflammation of kidneys is the characteristic pathological states corresponding to Apis mellifica.
• Extreme sensitiveness to touch and general soreness is marked. Much prostration.
• Pain in both kidneys (bright’s disease). Renal pains; soreness; pressure on stooping.
• Burning and soreness when urinating.
• Urine suppressed, loaded with casts; frequent and involuntary; stinging pain and strangury;
• Urine scanty, high coloured. Last drops burn and smart.
• Suppression of urine.
• “Acute inflammatory affection of kidneys, with albumin in urine.
• Typical Apis mellifica is thirstless: intolerant of heat.

Argentum nitricum

• Touching the kidney region increases the pain to the highest degree.
• Acute pain of  kidneys, extends down ureters to bladder; worse slightest touch or motion, even deep inspiration.
• Typical Argentum nitricum has apprehension. Gets diarrhoea from anticipation.
• Craves sweets, which disagree: salt.
• Is nervous: hurried: walks fast.

Arsenicum album

• Homoeopathic medicine for chronic renal failure having inflammation of kidney with stitches pain in renal region; on breathing or sneezing.
• Debility, exhaustion, and restlessness, with nightly aggravation, are most important.
• Great exhaustion after the slightest exertion.
• Urine, dark-brown; dark yellow: turbid: mixed with blood and pus; greenish.
• Urine like thick beer; rotten smell. Suppression of urine.
• Extreme restlessness, anxiety, prostration.

Belladonna

• Stinging, burning pain, from region of kidneys down into bladder.
• “No remedy has a greater irritation in the bladder and along the urinary tract.”
• Pains clutch: come and go suddenly.
• Typically, has redness, great heat to touch.

Benzoicum acidum

• Kidney pains, which penetrate the chest on taking a deep breath.
• Sore pain in back: burning in left kidney; with drawing pain when stooping.
• Urine of a very repulsive odour. Pungent. Contains mucus and pus.
• Strong, hot, dark-brown urine.

Berberis vulgaris

• Soreness in lumbar region and kidneys.
• Can bear no pressure: no jar Has to step down carefully.
• Jar or jolt intolerable.
• Burning; burning stitches, loins and kidneys.
• Sore kidneys with urinary disturbances.
• Has bubbling sensation, and pains that radiate from a point.
• “Pain in back a chief indication for Berberis vulgaris.”

Cantharis vesicatoria

• The whole urinary organs and genitalia are in a state of inflammation and irritation.
• Discharge of bloody urine burns like fire.
• Intensity and rapidity are the features of this remedy.
• Homoeopathic medicine for chronic renal failure having dull pressing or paroxysmal cutting and burning pains in both kidneys: very sensitive to slightest touch.
• Urging to urinate. Painful evacuation, by drops, of bloody urine, or pure blood.
• Intolerable urging, before, during and after urination.
• Violent, acute inflammation.

Mercurius corrisivus

• Inflammation of kidney with diminished secretion of urine, with great desire to pass it.
• Urine saturated with albumin.
• Dark brown: mixed with blood: with dirty white sediment.
• Violent and frequent urging to urinate.
• Urine dark-red; becomes turbid and foetid: smells sour and pungent.
• Burning and scalding sensation during urination as from raw surfaces.
• Worse at night.

Stramonium

• Kidneys secrete less urine or none, in acute diseases, in children, in eruptive fevers, etc.
• Great desire to urinate, though secretion is suppressed.
• Urine dribbles away very slowly and feebly.
• Retention: sensation urine could not be passed, because of narrowness of urethra.
• After straining, a few drops are passed.
• Better after drinking vinegar.

Terebinthiniae oleum

• “Congestive kidneys, with dull aching, and smoky-looking urine.”
• Violent burning and drawing pains in kidneys, bladder and urethra.
• Pressure in kidneys when sitting; relieved by motion.
• Stiff all over; heaviness and pains in region of kidneys.
• Renal disease producing dropsy. Rapid attack with lumbar pain.
• Urine greatly diminished: loaded with albumen: contains casts and blood.
• Urine smoky: with “coffee grounds” or thick, slimy, sediment.
• “Haemorrhage from all outlets, especially in connection with urinary or kidney troubles.”
• Kidneys inflamed: feet swollen.
• Urine: profuse, light yellow: contains sugar: foams, scanty, exceedingly dark.
• Pain left kidney to epigastrium.

Conclusion:

Homoeopathy can give better life support to patient having CKD. Homoeopathic treatment helps in both prolonged life and improving quality of life. Homoeopathic treatment can reduces frequency of haemodialysis.Patient with both hemodialysis and on homoeopathic treatment have better life then patient only on haemodialysis.

References :-

1. Sarkar BK, Hahnemann’s Organon of Medicine, 9^th revised edition, Delhi, Birla Publication(P) LTD, 2003-2004, 164
2. Robert HA, The principles of art of cure by Homoeopathy, reprint 2015, New Delhi, Indian Books & periodicals publishers, 208-217
3. Davidson’s Principles & Practice of Medicine, 23^rd Edition, Edinburgh, Elsevier, 2018, 415-420.
4. Harrison,  Internal Medicine,20 ^th Edition McGraw-Hill, 2018, Vol. 1, 752
5. Bhatiya M, Homoeopathy for chronic renal failure with list  of commonly indicated homoeopathic medicine for chronic renal failure,Hpathy, August 28,2009. Available from: https://hpathy.com/cause-symptom-tretment/chronic-renal-failure/
6. Chronic renal failure. Available from: https://images.app.goo.gl/dcAmvpz4nUuW2Aph7
7. Ortega P. S. Notes on Miasms, 1^st edition, New Delhi, National Homoeopathic Pharmacy, 1980, 183-191.
8. Lilienthal S, Homoeopathic therapeutics-The classical hints, 24^th Impression, New Delhi, B Jain Publisher (P) LTD., 2016, 769-771

About the authors:

Dr Bhavita Malvi,

(PhD scholar),

Assistant professor,

Department of Anatomy,

Parul Institute of Homoeopathy & Research,

Parul University,

Vadodara, Gujarat

Dr. Megha Parmar,

Assistant professor,

Department of Homoeopathic Pharmacy,

Arihant Homoeopathic Medical college,

Kalol, Gujarat