INDEX

S.NO. ARTICLE AUTHOR
1 A Comparison of the remedy picture with the phychological profice of the cancer personality Dr. Harsh Nigam M.B.B.S., M.D., M.F. (Hom.), Kanpur
2 Chronic Renal Failure Dr. Harsh Nigam M.B.B.S., M.D., M.F. (Hom.), Kanpur
3 CLINICAL VERIFICATION OF HOMOEOPATHIC DRUGS IN PSORIASIS Dr. Rajeev Shukla B.Sc., B.H.M.S. (Hons London),Kanpur
4 BEHAVIOURAL PROBLEMS AND ABNORMAL PSYCHOLOGICAL ASPECTS OF CHILDREN Dr. Manish Jain B.Sc., B.H.M.S., H.M.D. (LON), Kanpur
5 PROBLEMS OF MENTALLY SUBNORMAL ADOLESCENTS Dr.Kanta Chhabra D.I. (HOM)London, Kanpur
6 MENOPAUSAL SYNDROME Dr. Poonam Sharma B.H.M.S , Kanpur
7 HOMOEOPATHIC TREATMENT OF AIDS Dr. Durgesh Gupta, Lucknow
8 SPORTS INJURIES & HOMOEOPATHIC TREATMENT Dr. Anil Kumar Jain (Lucknow)
9 When your hand refuses to write Dr. Jintendra Shukla, Lucknow
10 PROSTATE AND HOMOEOPATHY Dr. Sandeep Kumar Mishra, Kanpur
11 SCOPE OF HOMOEOPATHY IN HEAD INJURY Dr. Santosh Tiwari, Kanpur
12 IF YOU HAVE HIGH BLOOD PRESSURE Dr. Parth Sarthi Sharma , Agra
13 ROLE OF HOMOEOPATHY IN SURGICAL CASES DR. PAWAN PAAREEK ,AGRA
14 Dioscorea Villosa in the Treatment of Brown sugar Addiction Dr. Prabhat Kulshreshtha, Agra
15 Psoriasis & Vitiligo DR ABHISHEK BHARTI, Sitapur
16 THE BLOOD AND BLOOD CANCER Dr. Rajendra Kumar ,Ghaziyabad
17 CHOLESTEROL AND THE HEART Dr. Rajendra Kumar,Ghaziyabad
18 Gall Bladder Stone & Kidney Stone Dr. Rajendra Kumar,Ghaziyabad
19 CANCER Dr. Rajendra Kumar,Ghaziyabad
20 OBESITY Dr. Rajendra Kumar ,Ghaziyabad
21 RECOMENDATIONS OF DIET FOR VARIOUS DISORDERS
22 मानव स्वास्थ निरोगी शरीर Dr. Ashok Kumar , Kanpur
23 अपराध और होमियोपैथी Dr. K.L Adarsh, Kanpur
24 होमियोपैथी के द्वारा कैंसर का इलाज़ संभव Dr. Sayad Manzar Azami,Kanpur
25 गाय और बैश भैंस के बंधत्वा और होमियोपैथी उपचार Dr. S.K. Parihaar,Lucknow

2.   Chronic Renal Failure

Dr. Harsh Nigam M.B.B.S., M.D., M.F. (Hom.)
Website: www.medicalhomoeopathy.in

DEFINITION

CRF consists of a persistent impairment of both glomercular and tubular function of gradual onset and of such severity that the kidney are no longer to maintain homeostasis

Causes of CRF

Glomercular Nephritis in its several forms, was the most common initiating cause of CRF in the past, possibly because of its aggresive treatment, Diabetes melltitus & Hypertensive renal disease are now the leading cause of CRF.

STAGES OF CRF

Early CRF: tGFR is reduced to 35-50% of normal.

Symptomatic CRF: GFR is reduced to 20-35% of normal.

Overt Renal Failure (ESRD) : t GFR is reduced to less than 20%. of normal (ESRD - End stage renal Disease) CERTAIN IMPORTANT WORDS NEED CLARIFICATION

l Bright's disease l Chronic Interestial Nephritis l Chronic Parenchymal Nephritis BRIGHT'S DISEASE / NEPHROTIC SYNDROME

This is a term applied to a syndrome of:

l Renal Disease l Presence of albumin in the urine l Dropsy The term Nephritis and inflammation of the kidney are applied to the same condition.

NEPHRITIS IS DIVIDED INTO THREE TYPE Acute Nephritis /ARF Sub Acute Nephritis/ Early CRF: The disease in which the acute form is passing off with

(i) Chronic Parenchymatous Nephritis/Symptomatic CRF: Secretary tissue of kidney is effected

(ii) Chronic Interestial nephritis/ESRD: Secretary tissue is fibrosed + Degenerative Global Vascular Disease +Cystic Changes in kidney.

UREMIA: Uremia is the term generally applied to the clinical syndromes that result from profound loss of renal function. However uremia involves more than renal excretory failure alone. A host of metabolic and endocrine function is also impaired.

The course of renal failure often accompanied by:

l Anemia

2. Malnutrition

l Impaired metabolism of carbohydrates, Fats and Proteins defective utilization of energy.

l Uremia refers to the constellation of signs and symptoms associated with CRF irrespec of cause.


SIGNS AND SYMPTOMS


l Early CRF (GFR: 35-50%) : Mostly asymptomatic because overall renal function is sufficient to keep the patient symptom free, although renal reserve is diminished. At this stage, BUN and Serum Creatinine levels may be normal or slightly elevated.

l Symptomatic CRF(GFR: 20-35%) : Azotemia present & initial manifestation of renal insufficiency appear although patients are still relatively asymptomatic renal reserve is severely compromised and sudden stress (UTI/Intercurrent Infection/ Urinary Tract Obstruction/ Dehydration/ Nephrotoxic Drugs )may compromise renal function so that signs & symptoms of overt uremia developed.

l ESRD (GFR<20%): Overt uremia present.


INVESTIGATION


(I) Rough estimate of GFR are Serum Creatinine and blood urea nitrogen.
(ii) Biochemical status - S.sodium/S.potassium/S.phosporus/S. Calcium
(iii) Serum - uric acid
(iv) CBS esp. Hb%/ platelet count
(v) Lipid profile
(vi) LFT (Liver Function Test)
(vii) USG: small & contracted kidney is a hallmark of CRF
(viii) Urine Analysis


MANAGEMENT OF PROGRESSIVE RENAL FAILURE


l Conservative Management (Non dialysis/Non transplant)
l Dialysis
l Renal Transplant


AIMS OF HOMOEOPATHIC MANAGEMENT CONSERVATIVE MANAGEMENT & HOMOEOPATHY


l To control symptoms
l Minimize complication
l Prevent long term sequels
l Slow the progression of renal insufficiency
l Reverse renal insufficiency


MANAGEMENT OF PROGRESSIVE RENAL FAILURE


l Delay the onset of dialysis
l Reduced the frequency of dialysis


MANAGEMENT OF PROGRESSIVE RENAL FAILURE


Manage complication of dialysis like:
- Cramps
- Hepatitis / Idiopathic Ascitis / Pruritis
- Bleeding diathesis


PRINCIPLES OF MANAGEMENT OF PROGRESSIVE RENAL FIALURE


l Strict control of blood sugar if patient is diabetic
l Strict control of hypertension
l Manage fluid retention
l Manage Anemia which is due to depressed erythropoiesis
l Secondary Hyperparathyroidism is best treated by reducing the serum phosphate con centration through the use of: - Phosphate restricted diet
- Phosphate binding agents
l Correct hyper Urecemia if present
l Metabolic acidosis must be corrected
l Avoid excess salt ingestion (excess sodium will contribute to or aggravate CHF, HTN, Ascites, Edema)
l Avoid excess water intake (leads to hyponatremia and weight gain)
l Maintain potassium level and hypercalcemia which has effect on cardiac function.


Therapeutic Approach


Specifics: Prescribed on the basis of presenting syndrome.
Drainage: To detoxify internal environment these medicines are of prime importance.
Classical Homoeopathy: Based on totality of symptoms. Single drug at one time.
Miasmatic Prescribing: To clear the miasmatic background. These medicines work remarkably well in work dramatically specially in 'stuck' cases. They rally the curative forces. The never been well since scenario : Medicines based on NBWS (Stressor) ARF or Acute on Chronic Renal Failure. Small Remedies : Small remedies are not 'small' in their effect only they are not well proven but if they fit the case they work.
Layered Prescribing : Most useful approach but requires experience

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