Kidney
Failure and how Homeopathy can help
Our Kidneys which are
also called the master chemist of the body maintains the electrolytic balance
of the body fluid, maintains the osmolarity and acid – base balance.
1.
The kidneys are the key organs to maintain the balance of the different
electrolytes in the body and the acid-base balance. In case of Kidney failure progressive
loss of kidney function results in a number of adaptive and compensatory Renal
and Extra-renal changes that allow homeostasis to be maintained with Glomerular
filtration rates in the range of 10-25 ml/min. With Glomerular filtration rates
below 10 ml/min, there are almost always abnormalities in the body's internal
environment with clinical repercussions.
2. Water Balance Disorders:
In advanced chronic kidney disease (CKD), the range of urine osmolarity
progressively approaches plasma osmolarity and becomes isostenuric. This
manifests clinically as symptoms of nocturia and polyuria, especially in tubulointerstitial
kidney diseases. Water overload will result in hyponatremia and a decrease in
water intake will lead to hypernatremia. Routine analyses of serum Na levels is
performed in all patients with advanced CKD. Except in edematous states, a
daily fluid intake of 1-1.5 liters should be recommended. Hyponatremia does not
usually occur with Glomerular filtration rates above 10 ml/min. If it occurs,
an excessive intake of free water should be considered or nonosmotic release of
vasopressin by stimuli such as pain, anesthetics, hypoxemia or hypovolemia, or
the use of diuretics. Hypernatremia is less frequent than hyponatremia in CKD.
3.
Sodium Balance Disorders: In CKD, fractional excretion of sodium increases
so that absolute sodium excretion is not modified until Glomerular filtration
rates below 15 ml/min. Total body content of sodium is the main determinant of
extracellular volume and therefore disturbances in sodium balance will lead to
clinical situations of volume depletion or overload: Volume depletion due to
renal sodium loss occurs in abrupt restrictions of salt intake in advanced CKD.
It occurs more frequently in certain tubulointerstitial kidney diseases (salt
losing nephropathies). Volume overload due to sodium retention can occur with
Glomerular filtration rates below 25 ml/min and leads to edema, arterial
hypertension and heart failure. The use of diuretics in volume overload in CKD
is useful to force natriuresis. Weight and volume should be monitored regularly
in the hospitalized patient with CKD.
4. Potassium Balance Disorders:
In CKD, the ability of the kidneys to excrete potassium decreases
proportionally to the loss of glomerular filtration. Stimulation of aldosterone
and the increase in intestinal excretion of potassium are the main adaptive
mechanisms to maintain potassium homeostasis until glomerular filtration rates
of 10 ml/min. The main causes of hyperkalemia in CKD are the following: Use of
drugs that alter the ability of the kidneys to excrete potassium: ACEIs, ARBs,
NSAIDs, aldosterone antagonists, nonselective beta-blockers, heparin,
trimetoprim, calcineurin inhibitors. Determination of serum potassium two weeks
after the initiation of treatment with ACEIs/ARBs is recommended. Routine use
of aldosterone antagonists in advanced CKD is not recommended. A low-potassium
diet is recommended with GFR less than 20 ml/min, or GFR less than 50 ml/min if
drugs that raise serum potassium are taken. In the absence of symptoms or
electrocardiographic abnormalities, review of medications, restriction of
dietary potassium and use of oral ion exchange resins are usually sufficient
therapeutic measures. Parenteral bicarbonate and ion exchange resins in enemas
are not recommended as first-line treatment. Hemodialysis is considered in
patients with glomerular filtration rates below 10 ml/min.
5. Acid-Base Disorders in CKD:
Moderate metabolic acidosis (Bic 16-20) mEq/L is common with Glomerular
filtration rates below 20 ml/min, and favors bone demineralization due to the
release of calcium and phosphate from the bone, chronic hyperventilation, and
muscular weakness and atrophy. Its treatment consists of administration of
sodium bicarbonate, usually orally (0.5-1 mEq/kg/day), with the goal of
achieving a serum bicarbonate level of 22-24 mmol/L. Limitation of daily
protein intake to less than 1 g/kg/day is also useful. Use of sevelamer as a
phosphate binder aggravates metabolic acidosis since it favors endogenous acid
production and therefore acidosis should be monitored and corrected if it occurs.
Hypocalcaemia should always be corrected before metabolic acidosis in CKD.
Metabolic acidosis is an infrequent disorder and requires exogenous alkali
administration (bicarbonate, phosphate binders) or vomiting.
Homeopathic Aspect
With
the help of Homeopathic medicines acid base balance along with Osmolarity can
be maintained. The electrolyte balance with symptoms can also be corrected with
Homeopathic medicines, moreover the Homeopathic medicines if used in high
dilutions (NANO Form) do not contain any crude drug material, hence are totally
harmless with no side effects.
