A Review on Chronic Renal Failure & its Treatment in Ayurveda

Chronic renal failure (CRF) is the progressive loss of kidney function. The kidneys attempt to compensate for renal damage by hyperfiltration in turn that causes further loss of function.

Chronic loss of function causes generalized wasting (shrinking in size) and progressive scarring within all parts of the kidneys. In time, overall scarring obscures the site of the initial damage. Yet, it is not until over 70% of the normal combined function of both kidneys is lost that most patients begin to experience symptoms of kidney failure.
CAUSES
The cause for can be determined by a detailed medical history, a comprehensive physical examination, and laboratory studies but it is difficult if not impossible. Even a kidney biopsy may be inconclusive, because all forms of kidney failure eventually progress to diffuse scarring and look the same on kidney biopsy. There are some identified disease conditions that may lead to CRF that can be categorized in three groups
1.Pre-Renal causes
Some medical conditions cause continuous hypoperfusion (low blood flow) of the kidneys, leading to kidney atrophy (shrinking), loss of nephron function, and chronic renal failure (CRF). Diabetes & Hypertension are most common
Multiple Myeloma, A type of cancer that begins in a type of white blood cell called plasma cells. Myeloma cells produce large numbers of proteins in the urine. These proteins often form deposits in the kidneys and cause kidney failure. In addition, multiple Myeloma increases the risk for hypocalcaemia and anemia and results in high blood levels of uric acid, which also increase the risk for chronic renal failure. Other conditions include poor cardiac function, chronic liver failure, and atherosclerosis of the renal arteries
2.Post-Renal causes
The disease conditions that interference with the normal flow of urine can produce backpressure within the kidneys & can damage nephrons. Abnormalities that may hamper urine flow and cause post-renal CRF include the following: Bladder outlet obstruction due to an enlarged prostate gland or bladder stone Neurogenic bladder, Kidney stones, Obstruction of the tubules, Retro- peritoneal fibrosis, the formation of fiber like tissue behind the peritoneum, the membrane that lines the abdominal cavity 3.Renal causes
Diabetic nephropathy, Hypertension nephrosclerosis, chronic glomerular nephritis, chronic interstitial nephritis, Renal Vasculitis, Cystic kidney disease, hereditary diseases of the kidney,

Signs and Symptoms of Chronic Renal Failure
Chronic renal failure (CRF) usually produces symptoms when renal function — which is measured as the glomerular filtration rate (GFR) — falls below 30 milliliters per minute (< 30 ml/min). This is approximately 30% of the normal value.

When the glomerular filtration rate (GFR) slows to below 30 ml/min, signs of uremia (high blood level of protein by-products, such as urea & creatinine) may become noticeable. When the GFR falls below 15 ml/min most people become increasingly symptomatic. Uremic symptoms can affect every organ system in the body& mainly are Neurological system– cognitive impairment, personality change, asterixis (motor disturbance that affects groups of muscles), and seizures. Gastrointestinal system–nausea, vomiting, food. Blood-forming system–anemia due to erythropoetin deficiency, easy bruising and bleeding due to abnormal platelets. Pulmonary system–fluid in the lungs, with breathing difficulties Cardiovascular system –chest pain due to inflammation of the sac surrounding the heart (pericarditis) and pericardial effusion (fluid accumulation around the heart) Skin –generalized itching
Diagnosis
CRF is diagnosed by the observation of a combination of symptoms and elevated blood urea nitrogen (BUN) and S.creatinine (Cr) levels. These abnormalities may signal CRF:
Anemia (low red blood cell count)
High level of parathyroid hormone
Hypocalcaemia (low blood level of calcium)
Hyperphosphatemia (high blood level of phosphate)
Hyperkalemia (high blood level of potassium)
Hyponatremia (low blood level of sodium)
Low blood level of bicarbonate
Low plasma pH (blood acidity
Low serum proteins, Presence of Proteins in Urine

Chronic renal failure nutrition should have a balance of fluids and electrolyte and adjusting the diet to prevent accumulation of toxic waste product to the minimum possible level. Chronic renal failure nutritional needs are as follows:
The food should be high in calories and low in protein.
Avoid canned, baked, processed and preserved foods.
Salted cheese, butter and nuts should be avoided
To reduce potassium content, vegetables should be cooked with more water and excess should be drained off.
Avoid fruits, fruit juices, and coconut water.
If potassium is restricted avoid tea, coffee, bajra, maize, ragi, wheat flour, pulses and legumes, chocolates, vegetables, fruits, sauces, jam, jellies.

Ayurveda Treatment for CRF
Prevention is always the goal with kidney failure. Chronic disease such as hypertension and diabetes are devastating because of the damage that they can do to kidneys and other organs. Lifelong diligence is important in keeping blood sugar and blood pressure within normal limits. Specific treatments are dependent upon the underlying diseases.
Once kidney failure is present, the goal is to prevent further deterioration of renal function. If ignored, the kidneys will progress to complete failure, but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved. The herbal/ Ayurveda products can be taken along with other types of medicines & treatments /procedures including dialysis.
A lot of herbal treatments are available for renal failure. The goals of treatment for renal failure are to:
1.To improve the status of protein & fat metabolism. 2.Correct or treat the cause of kidney failure.
3. Support the kidneys until they have healed and can work properly.
4.Prevent or treat any complications caused by acute renal failure

Chronic Renal Failure Management in Vedanta Ayurveda
More then 1200 cases of CRF has been treated so far by Dr. Prasher, among them45 % were on dialysis & in about 60% of these cases on an average after 9 months the requirements of dialysis was not there.
The cases that were on there initial state among them 40% of patients were recovered completely after 2-3 years of treatment. In about 20% of cases very little/ no effect could be observed.
To check any chronic renal failure, firstly we studying the ongoing disease process and identifying the state of disease and the nature of diseased .We provide personalized herbal formulations developed from VARUNA, PUNARNAVA, ARJUNA, VASA, KATUKI, NISHOTHA, DHARVI, KANCHANAR, BALA, NAGHARMOTHA, BUMIAMALAKI, SARIVA, ASHVAGANDHA, PANCHATRINAMULA and others.