Chronic renal failure (CRF) is the progressive loss of kidney function. The kidneys attempt to compensate for renal damage by hyperfiltration (excessive straining of the blood) within the remaining functional nephrons (filtering units that consist of a glomerulus and corresponding tubule). Over time, hyperfiltration 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.
Types
Chronic renal failure (CRF) can be classified by the site (location) of primary damage:
Chronic renal failure (CRF) can be classified by the site (location) of primary damage:
Pre-renal CRF
Post-renal CRF(Obstructive Uropathy)
Post-renal CRF(Obstructive Uropathy)
Renal CRF
Causes
The cause(s) of CRF sometimes can be determined by a detailed medical history, a comprehensive physical examination, and laboratory studies. More often than not, determining the cause of CRF 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.
The cause(s) of CRF sometimes can be determined by a detailed medical history, a comprehensive physical examination, and laboratory studies. More often than not, determining the cause of CRF 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.
Pre-Renal CRF 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). These conditions include poor cardiac function, chronic liver failure, and atherosclerosis ("hardening") of the renal arteries. Each of these conditions can induce ischemic nephropathy
Post-Renal CRF Interference with the normal flow of urine can produce backpressure within the kidneys, can damage nephrons, and lead to obstructive uropathy, a disease of the urinary tract. 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, an overdistended bladder caused by impaired communicator nerve fibers from the bladder to the spinal cord
Kidney stones in both ureters, the tubes that pass urine from each kidney to the bladder
Obstruction of the tubules,the end channels of the renal nephrons
Retroperitoneal fibrosis, the formation of fiberlike tissue behind the peritoneum, the membrane that lines the abdominal cavity
Vesicoureteral reflux (VUR), the backward flow of urine from the bladder into a ureter
ROLE OF HOMOEOPATHY
Homoeopathy does not recognise kidneys as a mere organ of excretion or selective filtration but always recognises it in relation to the individual as a whole. Kidneys have a generalised function--the fluids coming to it and going from it influence every organ, tissue and cell of our body. Kidney function influences the complete vital economy of our body. It is very important to study the mental picture of patients with primary kidney diseases.
Fear, Anxiety and Shocked State of Acute Renal failure Depression and Underlying Mental Uneasiness of Chronic Renal failure. Kidneys are associated with deep emotional life. There are definite "Renal types" of patients."Renal type" of patients--They always have an organic fear. They are afraid of having some hidden illness.
The state of patient with end stage renal failure or progressive reversible chronic renal disease is very pathetic not only for the patient itself but also for the family and society as a whole. The individualised homoeopathic therapeutic modality considering the patients psychological presentation is very important. Homoeopathy does wonders here and has prevented a large number of cases progressing to Hemodialysis and Renal Transplant.
The usual presentation of C.R.F. in Homeopathic hospital includes: 1. Patients with just diminished renal reserve. 2. Patient with End Stage Renal Failure pending Hemodialysis and Renal Transplant. 3. Patient already on long term Dialysis pending Renal Transplant. 4. Post Renal Transplant Patients.
1. Patients with just diminished renal reserves: This is the best field for us to work but unfortunately, the number of cases presenting at this stage are very few. The individualised homoeopathic treatment does wonders here and have prevented a large number of cases progressing to stage of dialysis or renal transplant. The usual symptomatic presentation at this stage is vague with patients mostly complaining of nausea, anorexia and progressive weakness. The laboratory renal parameters are also not very seriously disturbed. The evolution of individualised totality comprising of the mental sphere, habits, past and family history require lots of patience and labor but the results are marvellous. Homoeopathy has already done a yoeman service to the society here as hemodialysis and renal transplant are not within easy reach of majority of population in under- developed countries.
2. Patients with end-stage chronic renal failure pending Hemodialysis & Renal Transplant: This is the group of cases with maximum presentations in the clinics. Majority of these cases come to homoeopathic rescue as a last resort as they can't afford long-term dialysis and transplant. The other small group of patients want to know the benefits of Homoeopathic treatment over dialysis and if Homoeopathic treatment be carried along with Hemodialysis? The clinical judgment is individualized and varies for every patient. Remember the correlation of uremic symptoms with renal functions varies front patient to patient.
3. Patients already on long-term hemodialysis pending renal transplant: Homeopathy has a great role to play here. Research experiments in various hospitals reveals the following facts : (a) Indicated homoeopathic remedies reduced the number of dialysis needed over a period of time. (b) Indicated homoeopathic remedies reduce and overcome the complications associated with chronic dialysis therapy. Complications of dialysis & its Homeopathic Management Remember a chronic dialysis patient depends on a machine for his life. These patients develop a variety of psychiatric, neurologic and somatic disorders. A neurologic disorder 'Dialysis dementia' is a characteristic example. In the mental sphere, these patients become very depressive, their reduced physical abilities make them sad and depressive .
In the physical sphere infections, thrombosis and aneurysm formation occur in the Arterio-venous fistula. There is a high incidence of septic embolisation in these cases. Heparin necessary during the hemodialysis procedures to prevent clotting leads to complications such as subdural hematoma and intracerebral hemorrhage.
4. Post Renal Transplant Patients: The group of patients coming for homoeopathic advice after Renal Transplant is very limited. Homeopaths have very little experience with these patients and the results are not very encouraging. Most of the symptoms here are marked and distorted by immune-suppressive therapy. Immuno-suppressive therapy suppresses all immune responses and hence Homoeopathic treatment has not much role to play in organ rejection of transplant cases. We have observed that those cases with renal failure, being put on Dialysis and if they receive homoeopathy medication simultaneously, they require less frequent dialysis and their quality of life improves.
How and Why Investigations For patients suffering from renal disorders, investigations become imperative to determine the cause and nature of the renal disease. Early detection ensures proper management of renal dysfunction. For Homoeopaths too, this understanding will lead to better management and prognosis.
