• October 21, 2022
• Uncategorized
• drjoshi
• 2 Comments

A study shows that 10% of the population worldwide suffers from chronic kidney disease, and millions die each year due to lack of access to affordable treatment. The study also reports  that more than 2 lakh people are diagnosed with renal disease each year in India.

Kidneys are the bean-shaped organs that rest under the rib cage, towards the back. Kidneys are called the drainage system of the body as their primary function is to filter out the blood and toss out the toxins and waste in the form of urine.  

What is Chronic Kidney Disease (CKD)?

Chronic kidney disease also known as chronic kidney failure is a condition marked as the gradual loss of kidney function over time. In other words, kidneys lose their ability to eliminate bodily waste, maintain the body’s fluids and control production of RBCs in the body.  

There are myriad reasons for kidney failure but the 2 chief causes are- 

• High Blood Pressure 
• Diabetes

Other causes- 

• Polycystic Kidney Disease 
• Glomerular Diseases 
• Lupus 
• Viral infections like HIV, Hepatitis B and C
• NSAIDs (Non steroidal anti inflammatory drugs)
• Tumors or Cancer in the kidneys 

Kidney failure and chronic disease bring out different symptoms in different people. They can be listed as follows- 

• Dry or itchy skin
• Shortness of breath and fatigue  
• Mental confusion and hard time concentrating 
• Muscle spasms 
• Nausea or vomiting, bad taste in the mouth 
• Excessive urine or no urine, abnormal urine output

Since the CKD progresses over the years, the National Kidney Foundation (NKF)  divided the kidney disease into 5 stages. This helps the nephrologists to determine the seriousness and provide appropriate treatment according to the stage the patient is on.  

Stage 1 

eGFR 90 or higher 

Symptoms 

• Urinary track infections 
• High blood pressure 
• Swelling in hands or feet 
• Blood or protein in the urine 

In the 1st stage of CKD most people do have any symptoms. This happens because even though the kidneys are not functioning at 100% they’re very efficient at performing their task. The fact that one kidney can work as well as two, we’re talking about the condition where both the kidneys are working, however, just a little less than 100%. Which is also why people suffering from stage 1 CKD do not usually find out about it until kidney disease reaches stage 3 or find out when they’re being tested for other conditions like high blood pressure or diabetes. 

Stage 2

eGFR 60-89

Symptoms 

• Urinary track infections 
• High blood pressure 
• Swelling in hands or feet 
• Blood or protein in the urine 

In the 2nd stage of CKD people do not have any symptoms. Often, symptoms of CKD do not start until stage 3. Given the situation, people are unaware of the fact that they’re on stage 2 of CKD. Nevertheless, nephrologists heed to certain signs when testing for kidney damage. 

Stage 3 

Stage 3A 

eGFR 45-59 

Symptoms 

• Muscle cramps 
• Lower back ache 
• Restless leg syndrome 
• Weakness or fatigue 
• Swelling in hands or feet 
• Urinating less or more than normal 
• Urine that is foamy, dark orange, brown, tea-coloured if contains blood.
• Dry or itchy skin 
• Trouble sleeping 

When CKD reaches 3rd stage, kidneys begin to affect the health and that is when most people start to notice symptoms. Yet, some people do not show any symptoms even at this stage. Stage 3A CKD results in mild or moderate loss of kidney function due to which the kidneys become less effective in filtering waste and fluid out of the blood, thereby causing waste to build up in the body. This waste build up is called uremia. Stage 3 CKD does not require dialysis or kidney transplant because1 the damage is moderate. However, stage 3 CKD cannot be cured or reversed but can be prevented from reaching stage 4 or 5 by appropriate treatment and maintaining a healthy lifestyle. 

Stage 3B

eGFR 30-44

Symptoms 

• Muscle cramps 
• Lower back ache 
• Restless leg syndrome 
• Weakness or fatigue 
• Swelling in hands or feet 
• Urinating less or more than normal 
• Urine that is foamy, dark orange, brown, tea-coloured if contains blood.
• Dry or itchy skin 
• Trouble sleeping 

When CKD reaches 3rd stage, kidneys begin to affect the health and that is when most people start to notice symptoms. Yet, some people do not show any symptoms even at this stage. Stage 3B CKD results in moderate or severe loss of kidney function due to which the kidneys become less effective in filtering waste and fluid out of the blood, thereby leading to waste building up in the body. This waste build up is called uremia. In this stage, people are likely to develop complications such as high blood pressure,  anemia (shortage of red blood cells) and early bone disease. Patients of stage 3 CKD may be referred to a dietitian because diet becomes an important part of the treatment. 

Stage 4

eGFR 15-20 

Symptoms 

• Fatigue 
• Extremity edema 
• Loss or decreased appetite 
• Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)
• Pain in the lower back 
• Nausea and vomiting 
• Bad breath due to urea build up in the body 
• Muscle cramps 
• Numbness or tingling in the toes or fingers 

Stage 4 CKD results in severe loss of kidney function. Most people are suggested to get dialysis or kidney transplant done at this stage. Due to poor functioning of kidneys, the waste materials or fluids start building in the blood, this condition is known as uremia.Furthermore, at this stage the patient is likely to develop grave complications like- 

• Anemia 
• Bone disease 
• High phosphorus 
• Heart disease 
• High potassium 
• High blood pressure  
• Abnormal levels of vitamin D 

Stage 5 

eGFR  Below 15 

Symptoms 

• Nausea or vomiting 
• Lower back pain 
• Very less or no urine 
• Shortness of breath 
• Fatigue or weakness 
• Loss of appetite 
• Muscle cramps 
• Swelling in hands, legs, eyes or lower back 
• Increased skin pigmentation 

 Stage 5 CKD is also known as end stage renal disease. This is the final stage where the eGFR falls below 15 ml/min indicating that kidneys are failing or close to failing. This stage calls for necessary dialysis or kidney transplant to prolong the patient’s life. The condition of the patient becomes overall severe as the kidney is no longer able to filter the blood and push out the waste materials, making the patient ill and weak. They fail to perform other functions like regulating blood pressure, creation of hormones that build red blood cells and activating vitamin D. The waste that builds up in the body causes several health problems such as – 

• Anemia 
• Bone disease 
• High blood pressure 
• Heart disease 
• Abnormal levels of vitamin D
• High potassium 
• High phosphorus 
• Metabolic acidosis 

Clinical / Conventional Treatments 

CKD progresses with time and when it reaches stage 4 or 5 it becomes life threatening. Hence, patients require medical intervention to sustain kidney failure. Once you’ve consulted a nephrologist, he/she will help you decide which treatment will be best for you- Dialysis or Kidney Transplant. 

• Dialysis

Dialysis is recommended to the patients of stage 4 or 5 CKD. Dialysis is a treatment to filter the blood and  flush out the waste materials from the body. It  impersonates a kidney and replaces its functions. However, dialysis can only do 10-15% of what an original kidney does. There are 2 types of dialysis- 

1. Hemodialysis 

Hemodialysis is a treatment that can be done in a center or patients home in presence of a care partner. The place is determined depending on the convenience of the patient. During the treatment, the patient’s blood travels through tubes from his body to the dialysis machine. When the blood is in the machine, it is filtered through  a man-made membrane called a dialyzer. The dialyzer filters the blood by removing all the toxins and extra fluid. The filtered blood is sent back to the body through the tubes. 

                    2. Peritoneal Dialysis (PD)

PD is a needle-free treatment. It can be performed at home as well as in the center. During PD, a catheter is used to fill the patient’s belly with a cleaning fluid called dialysate. Dialysate stays in the patient’s belly for a given period of time. It filters the blood inside. After a few hours the used dialysate is drained out and fresh dialysate filled in the belly. While the dialysate is in the belly the patient is allowed to perform daily activities. This treatment can be performed in presence as well as absence of a care partner. Usually, dialysate is kept in the belly for 6 hours. 

• Kidney Transplant 

Kidney transplant is a surgery in which non-functioning kidneys of a patient are replaced with  healthy or functioning kidneys of a living or deceased donor. During the procedure, an incision is made on the lower part of one side of the abdomen to insert a new kidney in the body. Patient’s kidneys are left untouched in their original place unless they cause any severe problem to the patient. 

• Diet 

Maintaining a healthy diet becomes necessary for an end stage renal disease patient. When a patient goes under the kidney transplant or dialysis, they have to restrict to a given list of proteins and carbs as the dialysis machine cannot perform filtering on the level of an original kidney.

Chronic kidney disease explained in Ayurveda 

The food that we intake is divided into two parts namely Sara bhaga and Kitta bhaga. Sara bhaga forms the rasa whereas the kitta bhaga forms the waste. Rasa fulfills the body’s nutritive requirement and waste is eliminated from the body as urine or sweat. As reported by ayurveda, sotras are the network of functional pathways in the body. These mutravaha sotras are responsible for the flow of urine in and out of the kidney. Any blockage in the sotras results in improper functioning of the kidneys. Blockage in the incoming channels causes shrinkage whereas blockage in the outgoing channels causes swelling. Due to the blockage, waste material starts building up in the body. This accumulation is known as ‘ama sanchaya’ in Ayurveda.  

Ayurvedic treatment for CKD

Clinical Treatments to some extent are stressful and expensive whereas ayurvedic treatment involves taking different herbs and making specific changes in diet (ahar) and lifestyle (vihaar). 

But the real question arises whether Ayurvedic treatment cures CKD or not?                 

Yes!                                                                                                                                                     

For years Ayurvedic treatments have been successful in improving the quality of life of patients with end stage renal disease, most importantly without dialysis or transplant. Through various natural herbs, medications and exercises Ayurvedic treatments aim to improve the health and kidney functioning of the patients. 

As per Ayurvedic point of view people suffering from end stage renal disease have distured agni which affects the process of formation and filtration of urine. Rasa, which meets the body’s nutritive requirements, is not formed leading to dosha and dhatu dhusti. Factors such as change in the eating habits, consumption of processed foods, intake of alcohol and tobacco and stress etc contribute to digestive impairment or Agni Mandya (Ayurvedic term). Ayurveda explains annavaha, rasavaha, udakavaha, medovaha, mutravaha and swedavaha srotodusti contribute to kidney failure.

The main concept of treating kidney failure or kidney damage in Ayurveda is to maintain the balance of Vata, Pitta and Kapha by changes in diet, lifestyle and through herbal medicines. 

Here are some of the herbs that help rejuvenate kidneys by improving overall functioning of the kidney- 

1. Punarnava 

Punarnava is widely known to revitalize the kidney and maintain healthy fluid balance in the body. Its anti-inflammatory properties reduce swelling in feets and hands; in other words, it cures edema.

2. Kaansi

Kaasi is the finest herb that treats all types of kidney diseases. It helps in reducing uric acid levels of the body thereby reducing joint pain and swelling. It is known for providing relief from chronic constipation and maintaining blood pressure. 

3. Varun 

Varun not only provides strength to the prostate gland but also improves urinary function. Lupeol, a chemical compound found in Varun, disables glycolate oxidase enzyme and prevents accumulation of oxalate in the body that averts stone formation in kidneys. Apart from this, it also helps to treat chronic headaches, intestinal bleeding and intestinal worms. 

4. Gokshur 

Gokshur boosts immunity and aids in digestion. It has antimicrobial and antibacterial properties that prevent urinary infection. It is also known for managing diabetes. It is a cooling herb which reduces inflammation. 

5. Palaash 

Palaash is listed as the top herb to enhance renal functioning. Host of anti-inflammatory properties reduces swelling. Moreover, it helps with digestive problems, cold and sore throat. 

Suggested dietary and lifestyle changes

• Control or decrease sodium intake through less consumption of salt in sea food, regular meals etc. 
• Regulate protein intake by avoiding inclusion of  protein rich food in your diet. Meat, dairy products, eggs, seeds and nuts etc are rich in protein. 
• Manage potassium intake by opting for a food that is not rich in potassium such as carrots, apples, oranges and orange juice, papaya etc. 
• Consumption of fatty foods like egg yolks, seeds, butter etc should be avoided at all costs. 
• Keep away from alcohol and smoking. 
• One must also control consumption of hot spices, peppers, chillies etc.
• Avoid any kind of stress. It is important to stay calm and relaxed. 
• Do not hold the urine 
• Avoid heavy meals after dark 
• Avoid daytime sleep and exercise regularly 

Conclusion 

Kidney failure is curable in ayurveda. With the right diet and medicinal herbs patients have observed improvement in their health. Ayurvedic medications have not only provided relief from the symptoms but have shown potential to reverse kidney failure from all the stages of condition.