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Renal failure is a sudden or gradual
loss of the kidney's ability to excrete wastage. It
is also known as Kidney failure. The sudden set on
is medically termed as Acute Renal failure and the
gradual as Chronic Renal failure.
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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.
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What is the cause
for Renal Failure? |
The various etiologies of
renal failure can be grouped into three major categories:
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Pre renal -- those that decrease renal blood flow.
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Intra renal -- those that produce a renal parenchymal
insult.
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Post renal -- those that obstruct urine flow.
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.
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What are the symptoms? |
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What investigations are needed? |
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.
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Serum Creatinine
and BUN |
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.
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What Can I Eat? |
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."
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What is the treatment? |
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!"
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