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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.
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====II. Repairing the damage at kidneys (origin of disease)====
 
====II. Repairing the damage at kidneys (origin of disease)====
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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] , shilajatwadivati etc. with [[rasayana]] drugs like black bitumen (shilajatu) and Commiphora wightii (guggulu) are found very effective for this purpose.
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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)====
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Excessive physical and mental stress, day time sleep and night vigil are also restricted.
 
Excessive physical and mental stress, day time sleep and night vigil are also restricted.
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==Current research==
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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>
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Another study was conducted in 130 patients of diabetic nephropathy treated with oral administration of gokshuradi guggulu, bhumyamalaki, vasa and shilajatvadivati for 2 months. The data showed highly significant reduction in serum creatinine, blood urea and urinary excretion of albumin.<ref>Patel K, Gupta SN, Shah N. Effect of Ayurvedic management in 130 patients of diabetic nephropathy. Ayu. 2011;32(1):55-58. doi:10.4103/0974-8520.85727</ref>
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In a study, sixty-four non-dialysis CRF patients with stage IV or V at base line and having record of  laboratory investigations of the preceding 6 months were studied. The treatment protocol included enemas (niruha-basti) containing 40 ml punarnavadi kwatha daily one hour before lunch for one month. Oral medications like gokshuradi guggulu, varunadi kwatha, rasayana churna, bhumyamalaki, shilajatwadivati, and chyavanaprasha were given for six months. Renal function tests (RFTs) were evaluated at various time points, i.e 6 months before baseline (TP -6), at baseline (TP 0), and after completion of 6 months of treatment (TP +6). After six months of Ayurvedic treatment, statistically and clinically significant improvements of eGFR, serum creatinine, blood urea, and hemoglobin and a significant shift to better CRF stages were observed in this study.<ref>Patel M, Patel M, Patel K, Wischnewsky M, Stapelfeldt E, Kessler CS, Gupta SN. Deceleration of Disease Progress Through Ayurvedic Treatment in Nondialysis Stages IV-V Patients with Chronic Renal Failure: A Quasi-Experimental Clinical Pilot Study with One Group Pre- and Postdesign and Two Premeasurements. J Altern Complement Med. 2020 May;26(5):384-391. doi: 10.1089/acm.2019.0419. Epub 2020 Mar 30. PMID: 32223566.</ref>
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[[File: EGFR.JPG|500px|'''Image 1: Estimated marginal means of eGFR'''|thumb]]
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[[File: Creatinine.JPG|500px|'''Image 2: Estimated marginal means of creatinine'''|thumb]]
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[[File: Hemoglobin.JPG|500px|'''Image 2: Estimated marginal means of hemoglobin'''|thumb]]
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==Possible modes of action==
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*Mental positivity
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*Deceleration of disease process
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*Reversal of pathology in mild affected units
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*Adaptation
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*Compensation
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      -by intact  nephrons
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              -by other organs
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Clinical Studies on effect of Ayurvedic treatment on dialysis dependent patients are under progress.
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References:
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