Chronic Kidney Disease

Chronic renal failure is a slowly worsening loss of the ability of the kidneys to remove wastes, concentrate urine, and conserve electrolytes.

Chronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss of renal function over a period of months or years. The symptoms of worsening kidney function are unspecific, and might include feeling generally unwell and experiencing a reduced appetite. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. Chronic kidney disease may also be identified when it leads to one of its recognized complications, such as cardiovascular disease, anemia or pericarditis.

Chronic kidney disease is identified by a blood test for creatinine. Higher levels of 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 urinalysis (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.

Recent professional guidelines classify the severity of chronic kidney disease in five stages, with stage 1 being the mildest and usually causing few symptoms and stage 5 being a severe illness with poor life expectancy if untreated. Stage 5 CKD is also called established chronic kidney disease and is synonymous with the now outdated terms end-stage renal disease (ESRD), chronic kidney failure (CKF) or chronic renal failure (CRF).

Causes

The most common causes of CKD are diabetic nephropathy, hypertension, and glomerulonephritis. Together, these cause approximately 75% of all adult cases. Certain geographic areas have a high incidence of HIV nephropathy.

Historically, kidney disease has been classified according to the part of the renal anatomy that is involved, as:

• Vascular, includes large vessel disease such as bilateral renal artery stenosis and small vessel disease such as ischemic nephropathy, hemolytic-uremic syndrome and vasculitis
  • Glomerular, comprising a diverse group and subclassified into

1. Primary Glomerular disease such as focal segmental glomerulosclerosis and IgA nephritis
   2. Secondary Glomerular disease such as diabetic nephropathy and lupus nephritis

• Tubulointerstitial including polycystic kidney disease, drug and toxin-induced chronic tubulointerstitial nephritis and reflux nephropathy.
  • Obstructive such as with bilateral kidney stones and diseases of the prostate.
  • Gout.

Symptoms

Initial symptoms may include the following:

• Fatigue
  • Frequent hiccups
  • General ill feeling
  • Generalized itching (pruritus)
  • Headache
  • Nausea, vomiting
  • Unintentional weight loss.
  • Anorexia.
  • Polyuria.
  • Nocturia.
  • Swelling of face.

Later symptoms may include the following:

• Blood in the vomit or in stools
  • Decreased alertness, including drowsiness,confusion, delirium, orcoma
  • 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 (uremic frost).
  • Hallucinations.
  • Fits.
  • Stupor.

Additional symptoms that may be associated with this disease:

• Abnormally dark or light skin
  • Agitation
  • Breath odor
  • Excessive nighttime urination
  • Excessive thirst
  • High blood pressure
  • Loss of appetite
  • Nail abnormalities
  • Paleness
  • diarrhoea.
  • Oliguria.
  • Dyspnoea.
  • Pain in chest.
  • Hiccough.
  • Cramps.
  • Bone pains.
  • Bruises.
  • Epistaxis.

Complications

• Anemia
  • Cardiac tamponade
  • Changes in blood sugar metabolism
  • Congestive heart failure
  • Decreased functioning of white blood cells
  • Decreased immune response
  • Decreased libido, impotence
  • Dementia
  • Electrolyte abnormalities including hyperkalemia
  • Encephalopathy
  • End-stage renal disease
  • Fractures
  • Hemorrhage
  • High blood pressure
  • Increased infections
  • Joint disorders
  • Liver inflammation (hepatitis B or hepatitis C)
  • Liver failure
  • Loss of blood from the gastrointestinal tract
  • Menstrual irregularities,mscarriage, infertility
  • Nerve damage
  • Pericarditis
  • Peripheral neuropathy
  • Platelet dysfunction
  • Ulcers
  • Seizures
  • Skin dryness, itching /scratching with resultant skin infection
  • Weakening of the bones
  • Uraemic coma.
  • Cardiac arrhythmia.

GENERAL MANAGEMENT

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

Homeopathic Treatment for Chronic Kidney Disease

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail Hpathy, please visit  Materia Medica section. None of these medicines should be taken without professional advice.

Homeopathic Remedies

Aconite

Incipient stage of post scarlatinal nephritis, pain in loins, scanty urine without blood.

Apis mellifica

Apis is not so much a remedy for chronic Bright’s disease as for the acuter forms. There are oedematous swellings of the face and extremities, paleness, ascites, oedema pulmonum, pains in the head, back and limbs. Albuminuria following scarlatina. It may be of use in any form of Bright’s disease when there are dull pains in the kidneys, scanty urine and frequent Micturition. The urine is heavily charged with albumen and contains blood corpuscles. The oedema appears quickly, there is general dropsy and suppression of urine and perhaps an eruption of the skin like a nettle rash. The patient? is drowsy, apathetic and has a bruised feeling all over. Apis in such cases acts best in trituration; do not depend on the tincture or dilutions. Hepar is recommended by Kafka in Bright’s disease following scarlatina. A valuable symptom for Apis is the feeling of suffocation. He does not see how he is get another breath.?

Apocynum

Palliative in dropsical conditions where the urine is scanty. Also useful for coma & convulsions in the nephritis of pregnency.

Arsenicum

This remedy corresponds to all stages of Bright’s disease, bearing a closer resemblance than any other remedy. It comes in later in the disease where there is dropsy, pale skin, waxen appearance, watery diarrhoea and great thirst. The urine is dark, casts are abundant, and it contains much albumen. There are attacks of dyspnoea when lying down in the evening and after midnight, relieved by an expectoration of

mucus. It may come in immediately after Aconite in many cases. “Blood boils” make a special indication for this remedy. Baehr, Millard and Hale question the usefulness of Arsenicum in kidney affections. However, it seems a simile to the large white kidney; in fact, one could hardly wish for a closer correspondence. Hughes considers it a favorite with anxiety and sinking of vital forces will call for Arsenicum. Calcarea arsenica has been used in the anaemia, progressive emaciation and debility of this disease with success.?

Aurum muriaticum

Morbus Brightii from gout, suppurations or syphilis. Interstitial nephritis in its incipiency with digestive and nervous phenomena, hypochondriasis, irritability and vertigo.?

Belladonna

Simple albuminuria, here it seems to occupy a place midway between Aconite and Arsenicum. Belladonna is of the greatest service in inflammation of the kidneys with piercing? burning pains in the lumbar region, returning periodically with increased severity.

Cantharis

This remedy pictures nephritis with cutting pains in the lumbar region; the urine is passed in drops and is mixed with blood, with much urging. Post scarlatinal and post diphtheric kidney diseases with dropsy may indicate Cantharis.

Convallaria

Nephritis from heart disorders. It affords relief when there is extreme rapid & irregular action of the heart, and in general anasarca & ascites from mitral insufficiency.

Cuprum arsenicum

Cuprum arsenicum is also useful in uraemic conditions and is praised highly by Goodno. Cuprum is a valuable remedy for uraemic eclampsia.

Digitalis

?This remedy has an irritant action on the kidneys. It is homoeopathic to granular degeneration. Heart symptoms, feeble pulse, scanty, dark, turbid urine, faintness at the stomach, rheumatic pains will indicate it. It is especially useful when the circulation is weak. Rheumatic pains, pulmonary catarrh with profuse expectoration are marked symptoms.

Glonoine

Glonoine has albuminous urine and will sometimes be found useful in acute and haemorrhagic nephritis.?

Kali chloricum

This remedy is said to be the most homoeopathic of all remedies in Bright’s disease. It has scanty, dark, albuminous urine containing casts. It excites a violent nephritis.?

Mercurius corrosivus

This remedy corresponds to the large white kidney. There is an albuminous, scanty and red urine; pale waxen color of the body; there are lumbar pains, great dyspnoea and excessive strangury. It takes the first rank among all the mercurials for nephritis, and it comes in the later stages. Syphilitic complication further indicate it. There is an expression of uneasiness on the face. Dr. Ludlam considers it our best remedy for the albuminous nephritis of pregnancy and Baehr lauds it in suppurative nephritis.

Plumbum

Granular degenerations of the kidneys, with tendency to uraemic convulsion. Dropsy, sallow face, emaciation, oedema about the ankles. It seems to corresponds to the contracted or cirrhotic form of nephritis, holding the same relation here that Arsenic and Mercury do in chronic nephritis. Royal emphasizes this remedy saying that it arrested the progress in many cases and permanently cured not few for him.

Phosphorus

Phosphorus produces as marked a nephritis as any drug. It is one of the most important remedies in Bright’s disease; the characteristic symptoms are: lassitude of? the whole body, hands and feet icy cold, sleepiness. The fatigue is greatest in the morning, and there is heat in the body without thirst, especially in the evening. The patient is indisposed to work, is giddy, forgetful and has a heavy headache, particularly in the forehead; there is oedema of the upper eyelids, a mist before the eye, a yellowish fray complexion, a sickly oedema of the face, want of appetite, pressure and burning in the stomach, and a light colored painless diarrhoea which is very weakening. It suits well fatty or waxy casts, is dark brown, scanty and albuminous, or covered with an iridescent film. Pulmonary complications will call for Phosphorus; and inability to lie on the left side is a prominent symptom in these cases. Vomiting and gastric symptoms are usually present. A small dose of Phosphorus will act much safer and better in eclampsia than a large dose of Morphine.?

Terebinth

One of our reliable and most frequently indicated remedies in the early stages of renal diseases when congestion is prominent, when there is much pain in the back of a? dull character extending along the ureters. The great characteristic of dark smoky urine will be present. There is anasarca, and of course, the urine is bloody and albuminous. It is recommended in post scarlatinal renal affections. The prostration is? not accompanied by the restlessness of Arsenicum.

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