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{{#seo:

|title=Kidney diseases  

|title=Kidney diseases  

|label3 = Reviewer  

|label3 = Reviewer  

|data3 = Basisht G.²

|data3 = [[Gopal Basisht|Basisht G.]]²

|label4 = Editors

|label4 = Editors

|data4 = Deole Y.S.², Aneesh E.G.², Basisht G. ²  

|data4 = [[Yogesh Deole|Deole Y.S.]]³, Anagha S.⁴  

|label5 = Affiliations

|label5 = Affiliations

|data5 = ¹ Distinguished Professor, Post Graduate Department of Kayachikitsa in J.S Ayurveda College, Nadiad, Gujarat, India

|data5 = ¹ Distinguished Professor, Post Graduate Department of Kayachikitsa in J.S Ayurveda College, Nadiad, Gujarat, India

⁴[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, Gujarat, India

|data6 = carakasamhita@gmail.com

|label7 = Date of first publication:

|label6 = Correspondence emails

|data7 = January 10, 2022

|data6 = guptayurveda@yahoo.com, carakasamhita@gmail.com

|label8 = DOI

|data8 = Under process

 

|label8 = Date of first publication:

 

|label9 = DOI

|data9 = 10.47468/CSNE.2022.e01.s09.079

}}

}}

<div style='text-align:justify;'>

<p style="text-align:justify;">This article is based on a lecture delivered by Prof. (Dr.) S.N. Gupta, Distinguished Professor, Post Graduate Department of Kayachikitsa in J.S Ayurveda College, Nadiad, Gujarat, India, in Prof. M. S. Baghel Memorial Lecture Series on December 09, 2021.

This article is based on a lecture delivered by Prof. (Dr.) S.N. Gupta, Distinguished Professor, Post Graduate Department of Kayachikitsa in J.S Ayurveda College, Nadiad, Gujarat, India, in Prof. M. S. Baghel Memorial Lecture Series on December 09, 2021.

 

==Incidence of chronic kidney disease==

==Incidence of chronic kidney disease==

There are no direct references in Ayurvedic classics regarding the role of kidneys in the process of formation of urine. The word pakwashaya (colon) is mentioned as the site of formation of urine. It should not be considered in anatomical or physiological aspects of conventional medicine. Ayurvedic texts emphasize more on therapeutic relevance of the organs. The description may not always match with modern views.  This concept has a very good therapeutic utility. The drugs and therapies having action on colon (pakwashaya) are successfully used for promoting proper formation of urine from its original site (kidney).

There are no direct references in Ayurvedic classics regarding the role of kidneys in the process of formation of urine. The word pakwashaya (colon) is mentioned as the site of formation of urine. It should not be considered in anatomical or physiological aspects of conventional medicine. Ayurvedic texts emphasize more on therapeutic relevance of the organs. The description may not always match with modern views.  This concept has a very good therapeutic utility. The drugs and therapies having action on colon (pakwashaya) are successfully used for promoting proper formation of urine from its original site (kidney).

Word vrikka is found in Rigveda but not as an organ but as a medicinal plant. According to Bhashya the word vrikka means ‘averter of diseases’. Thus, in similar manner we may understand the vrikka as organ also.  [Rigveda 1/187/10]

Word vrikka is found in Rigveda. However, it is not referred as an organ, but as a medicinal plant. According to Bhashya, the word vrikka means ‘averter of diseases’. Thus, in similar manner we may understand the vrikka as organ also.  [Rigveda 1/187/10]

Similarly, the word “vrukka” used for denoting kidneys indicate that it has the capacity of healing itself. This self-healing power of vrukka (kidney) shall be explored and promoted by Ayurvedic treatment.

Similarly, the word “vrikka” used for denoting kidneys indicate that it has the capacity of healing itself. This self-healing power of vrikka (kidney) shall be explored and promoted by Ayurvedic treatment.

==Chronic renal failure==

==Chronic renal failure==

Herbs having [[rasayana]] (rejuvenating) activities on urinary system (mutravahasrotas) should be used. Crataeva religeosa (varuna), Boerrhavia diffusa (punarnava), Tribulus terrestris (gokshura), and Phyllanthus niruri (bhumyamalaki) show potent rejuvenating activities on urinary system. The compound preparation called “Chyavanaprasha”, other preparations like Jivitapradavati [Bheshaj Samhita],<ref>Bheshajasamhita( Ayurvedic pharmacopeia)Edited by Gujarat state bheshaja samiti 1st edition, Ministry of health, Gujarat State; 1966 P 468-9</ref> shilajatwadivati etc. with [[rasayana]] drugs like black bitumen (shilajatu) and Commiphora wightii (guggulu) are found very effective for this purpose.

Herbs having [[rasayana]] (rejuvenating) activities on urinary system (mutravahasrotas) should be used. Crataeva religeosa (varuna), Boerrhavia diffusa (punarnava), Tribulus terrestris (gokshura), and Phyllanthus niruri (bhumyamalaki) show potent rejuvenating activities on urinary system. The compound preparation called “Chyavanaprasha”, other preparations like Jivitapradavati [Bheshaj Samhita],<ref>Bheshajasamhita( Ayurvedic pharmacopeia)Edited by Gujarat state bheshaja samiti 1st edition, Ministry of health, Gujarat State; 1966 P 468-9</ref> shilajatwadivati etc. with [[rasayana]] drugs like black bitumen (shilajatu) and Commiphora wightii (guggulu) are found very effective for this purpose.

====III. Establishing the normal state of [[srotas]] (mutravaha, udakavaha and swedavaha)====

'''III. Establishing the normal state of [[srotas]] (mutravaha, udakavaha and swedavaha)'''

In order to support the excretory functions and maintenance of fluid and electrolyte balance, the therapeutic procedure called ‘[[basti]]’ is found highly effective. The decoction enema (niruha basti) with punarnavadi kwatha, and unctuous enema (anuvasana basti) with gokshuradi taila, the drug Boerrhavia diffusa (punarnava) in a palatable and convenient form 3-5 g twice a day is advisable.

In order to support the excretory functions and maintenance of fluid and electrolyte balance, the therapeutic procedure called ‘[[basti]]’ is found highly effective. The decoction enema (niruha basti) with punarnavadi kwatha, and unctuous enema (anuvasana basti) with gokshuradi taila, the drug Boerrhavia diffusa (punarnava) in a palatable and convenient form 3-5 g twice a day is advisable.

The status of important electrolytes like sodium and potassium should be considered. In cases of hypernatremia and associated cardiac failure, salt should be restricted. Rock salt (saindhava lavana) is advisable if needed. In cases of hyperkalaemia, intake of fruits and vegetables should be restricted. In case of hypokalaemia, intake of fruits and coconut water is useful.

The status of important electrolytes like sodium and potassium should be considered. In cases of hypernatremia and associated cardiac failure, salt should be restricted. Rock salt (saindhava lavana) is advisable if needed. In cases of hyperkalaemia, intake of fruits and vegetables should be restricted. In case of hypokalaemia, intake of fruits and coconut water is useful.

====IV. Nourishment ofdhatu (body constituents)====

'''IV. Nourishment of dhatu (body constituents)'''

For correction of anaemia, Chyavanaprasha or any iron containing preparations are effective. Role of erythropoietin shall be considered here. If only the excretory function of kidney is impaired and endocrinal functions are proper, then erythropoietin supplementation is not needed. In case of deficiency of erythropoietin only, it should be supplemented. Fruits of prickly pear, beetroot are natural supplements having similar action to erythropoietin. These are used for promoting blood tissue ([[rakta dhatu]]).

For correction of anaemia, Chyavanaprasha or any iron containing preparations are effective. Role of erythropoietin shall be considered here. If only the excretory function of kidney is impaired and endocrinal functions are proper, then erythropoietin supplementation is not needed. In case of deficiency of erythropoietin only, it should be supplemented. Fruits of prickly pear, beetroot are natural supplements having similar action to erythropoietin. These are used for promoting blood tissue ([[rakta dhatu]]).

For managing myopathy and neuropathy, a very effective therapeutic measure is massage (abhyanga) with medicated oils. This pacifies aggravated [[vata dosha]].  For osteodystrophy, Shankhabhasma, compounds of mukta (pearl) and pravala (coral) are used. They are good natural source of calcium and also help in managing hyperacidity. Mukta is an antidepressant too.

For managing myopathy and neuropathy, a very effective therapeutic measure is massage (abhyanga) with medicated oils. This pacifies aggravated [[vata dosha]].  For osteodystrophy, Shankhabhasma, compounds of mukta (pearl) and pravala (coral) are used. They are good natural source of calcium and also help in managing hyperacidity. Mukta is an antidepressant too.

====V. Management of associated conditions====

'''V. Management of associated conditions'''

In cases of hypertension, Triphala guggulu 1gm three times a day along with powder of Terminalia arjuna (3g) is effective. The powder of Rauwolfia serpentina (sarpagandha) 500mg-1gm can also be given to control hypertension. Symptomatic treatments are given in cases of nausea, vomiting, hiccup etc.

In cases of hypertension, Triphala guggulu 1gm three times a day along with powder of Terminalia arjuna (3g) is effective. The powder of Rauwolfia serpentina (sarpagandha) 500mg-1gm can also be given to control hypertension. Symptomatic treatments are given in cases of nausea, vomiting, hiccup etc.

====VI. Psychotherapy====

'''VI. Psychotherapy'''

Proper counselling of the patients, giving positive outlook and assurance comes under sattvavajaya chikitsa. This has a great role in such conditions.

Proper counselling of the patients, giving positive outlook and assurance comes under sattvavajaya chikitsa. This has a great role in such conditions.

An extra 100 ml of boiled milk (cow’s) is also advisable during day time, if the patient feels hungry.

An extra 100 ml of boiled milk (cow’s) is also advisable during day time, if the patient feels hungry.

Food items to be avoided:

'''Food items to be avoided:'''

*All other flour items like wheat, millet, corn etc.

*All other flour items like wheat, millet, corn etc.

==Current research==

==Current research==

[[File: EGFR.JPG|500px|'''Image 1: Estimated marginal means of eGFR'''|thumb]]

[[File: EGFR_final.jpg|500px|'''Image 1: Estimated marginal means of eGFR'''|thumb]]

 

 

[[File: Hemoglobin_final.jpg|500px|'''Image 3: Estimated marginal means of hemoglobin'''|thumb]]

A clinical study of 100 patients of chronic renal failure (other than diabetic nephropathy) to study effect of [[ayurveda]] therapy was conducted. Decoction enema (niruha basti) with punarnavadi kwatha daily and oral administration of gokshuradi guggulu, rasayana churna and varunadi kwatha as per the protocol were prescribed for a period of one month. In this study, statistically significant results were obtained in levels of serum creatinine, blood urea and albumin in urine along with considerable relief in signs and symptoms.<ref>Patel MV, Gupta SN, Patel NG. Effects of Ayurvedic treatment on 100 patients of chronic renal failure (other than diabetic nephropathy). Ayu. 2011;32(4):483-486. doi:10.4103/0974-8520.96120</ref>

A clinical study of 100 patients of chronic renal failure (other than diabetic nephropathy) to study effect of [[ayurveda]] therapy was conducted. Decoction enema (niruha basti) with punarnavadi kwatha daily and oral administration of gokshuradi guggulu, rasayana churna and varunadi kwatha as per the protocol were prescribed for a period of one month. In this study, statistically significant results were obtained in levels of serum creatinine, blood urea and albumin in urine along with considerable relief in signs and symptoms.<ref>Patel MV, Gupta SN, Patel NG. Effects of Ayurvedic treatment on 100 patients of chronic renal failure (other than diabetic nephropathy). Ayu. 2011;32(4):483-486. doi:10.4103/0974-8520.96120</ref>

*Compensation by intact  nephrons/by other organs

*Compensation by intact  nephrons/by other organs

Clinical Studies on effect of Ayurvedic treatment on dialysis dependent patients are under progress.

Clinical Studies on effect of Ayurvedic treatment on dialysis dependent patients are under progress.

 

 

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