Renal decline and failure is a final common path way for a number of disease processes and associated with significant morbidity and mortality. It is very important to know the high frequency of this disease, the multiple causes, the significant morbidity and a logical clinical approach to renal failure which will help to illuminate the cause and then to proceed to a proper therapy.

               A decrease in renal function is sufficient to result in retention in the body of nitrogenous waste such as blood, urea, nitrogen and creatinine. The hall mark of renal failure is progressive azotaemia caused by the accumulation of the nitrogenous end products of metabolism. This accumulation is accompanied by a wide-range of other disturbances depending on the severity and duration of the renal dysfunction. These include metabolic derangements such as metabolic acidosis and hyperkalemia, disturbances of body fluid balance and effects on many other organ systems.

Pre renal

It results from a decrease in renal blood flow. The glomerular filtration rate is reduced and the kidney retains water and salt, causing Oliguria, production of concentrated urine and a progressive inability to excrete nitrogenous wastes.

Decreased blood flow is one cause of damage to the kidney. Acute renal failure may occur when there is extremely low blood pressure the patient may suffer from trauma, septic shock, haemorrhage, severe vomiting, diarrhoea, burns and associated dehydration or other severe or complicated illness.

Intra renal

Renal failure usually occurs as the internal structures of the kidney are suddenly or slowly destroyed. It is a complex collection of disease processes with a poorly understood pathophysiology. An inflammatory process is initiated in the renal parenchyma in response to a wide variety of stimuli such as toxic, metabolic, infectious, immune infiltrative and drugs are probably the most common causes. Most acute renal failure occurs as secondary to bacterial infection particularly with streptococcal such as the impetigo and throat infections. Chronic failure commonly noticed with hypertension and diabetes damage the vascular walls. Smoking causes atherosclerotic changes of the arterial walls.

Nephrotoxic drugs and metals could ruin the cellular complex as in prolonged chemical medication. Disorders in metabolism and immunity is also to be considered.

Post renal

A simple mechanical or functional obstruction to the free flow of urine precludes, its excretion and renal failure occurs. It commonly happens with kidney stones, urethral stricture and prostate enlargement.

            The symptoms are sudden in acute renal failure and gradual in chronic. The initial symptoms are noticed with renal physiopathology as reduction in urinary put out and accumulation of fluid.

The accumulation of waste products also produces impairment of mind and skin symptoms.
Frequent thirst and urge to urinate.
Passing of very small amount of urine, dark in colour.
Swelling particularly of the hands and feet and puffiness round the eyes.
Unpleasant taste in the mouth and urine like odour to the breath.
Persistent fatigue and shortness of  breath.
Loss of appetite and unintentional weight  loss.
Pale, dry and itchy skin.
Muscular cramps and twitching.
Headache, nausea, vomit and  hiccups.
Blood in vomit or stools likely.

                   Acute renal failure would make a patient rush to a doctor immediately. On the other hand, in the chronic failure there may be no symptoms. It is found on routine check-up. High blood pressure may be noticed. Blood and urine investigations alarm the patient.

                Urinalysis is one of the first and easiest tests that can be done on the patient with acute renal failure. It provides both diagnostic and prognostic information about the patient. A positive test for protein suggests intrinsic renal disease with glomerular damage.

               Microscopic examination of red blood cells, white cells, renal tubular epithelial cells, oval fat bodies, bacteria and crystals gives some information. Casts are formed from urinary protein. This protein tends to gel in conditions of high concentration when mixed with red cells, tubular cells or cellular debris. Thus the composition of this cast reflects the contents of the tubule.

                Hyaline casts are found in glomerular proteinuria. Red cell casts indicate glomerular hematuria, white cell casts imply the presence of renal parenchymal inflammation. Granular casts are composed of cellular remnants and debris. Fatty casts are usually associated with heavy proteinuria.

               The important point to be kept in mind about elevations of serum creatinine and blood urea nitrogen are late signs of renal dysfunction. Creatinine is formed in the breakdown of muscle creatinine and proportional to the muscle mass. It should be stable from day-to-day. Any changes in the serum creatinine level would usually be  a result of change in the glomerular filtration rate. Abrupt caessation of glomerular filtration causes the serum creatinine to rise by 1-3 mg/dl daily. Examination of serum electrolytes, calcium, phosphorus and magnesium are also to be considered.

              Intravenous Pyelogram  provides an anatomic picture of the kidney, but does not help to evaluate kidney function. Renal ultrasound is the most valuable diagnostic technique for the assessment of the patient with renal failure. Computerised Tomography can be helpful for some patients. Hydronephrosis can be recognized without contrast. The cause of obstruction can often be delineated.

              Watch your potassium intake. Monitor your sodium. You may even have to control your protein intake.

             Eggs, meat, fish, poultry, milk and other dairy products are rich in animal proteins. Peas, beans, soya beans, peanuts, grains and potatoes are rich plant proteins. Sodium, our common table salt, has to be reduced to lower the high blood pressure. Potassium will regulate your heartbeat and electrical impulses are also lowered. Oranges, potatoes and bananas are very rich in Potassium.

             Cauliflower is a wonderful substitute for renal failure patients.  It's a real comfort food and it's acceptably low in Potassium."
 

Safe Medicine

                      Primarily one has to choose the safest treatment. A damaged kidney does not tolerate the chemicals and metals in material doses for along time. The only suitable and curative treatment is in “Homoeopathy.” The reason for the medicines being effective is that these medicines are administered in diluted and dynamic form. They never produce any adverse effect on the kidneys. Homoeopathy has wide range of applications on the causative factors.

Dialysis and Transplantation

                       The prognosis of the patient depends only on the degree of damage. Acute renal failure can be rectified without any complications. They can be assured of the treatment. In chronic renal failure the prognosis is good compared to other systems of medicine.  In severely damaged conditions we can postpone their life-time. Dialysis and kidney transplantation are needed only when the creatinine and blood urea nitrogen are not controlled.

         I have treated some chronic and acute renal failure cases with great success. Most of the patients who suffer from Diabetes and Hypertension withdraw medications with the onset of kidney impairment. My personal opinion is that the modern medicines are good at treating acute disorders as they produce minimal damage to your vital organs. But they will not be suitable for chronic complaints, because they will produce both medicinal side-effect and adverse effect on other vital organs.

          Clinically, the patient’s predisposition can be detected with other ailments.

         Homoeopathic medicine is not applied on the disease name. We study the patient as a whole, thereby the dynamic remedy is selected on the basis of symptom similarity which possess the power of  "Magic Healing!"