PATHOGENESIS
Nephrotic syndrome occurs due to the injury to the podocyte cells of the glomerular apparatus which selectively (preventing red cells from moving out) passes out negatively charged protein particles into the urine causing low protein levels in the serum. This causes leakage of fluid from the vascular compartments into the interstitial spaces producing edema.
This also increases the compensatory tubular resorption of sodium and water to increase intravascular volume leading to edema.
CAUSES OF NEPHROTIC SYNDROME
Diabetes
SLE (Systemic lupus erythematosus)
Genetic disorders
Disorders of the immune system
Infective conditions
Drug related
HIV
AIDS
Amyloidosis
Pre-Eclampsia
SIGNS AND SYMPTOMS
MAJOR SYMPTOMS:
Facial swelling (puffy eyes)
Abdominal swelling
Pedal edema
Generalised anasarca in severe cases.
ASSOCIATED SYMPTOMS:
Respiratory tract infections, Allergies, Secondary infections, hypotension, diarrhea, hypertension etc.
NEPHROTIC SYNDROME IN CHILDREN
It commonly affects children between the ages of 1 yr to 4.5 yrs. congenital nephrotic syndrome may however appear in the first year of life.
It is again the same set of symptoms as explained above and manifests in the form of heavy proteins in urine with associated hypoalbuminemia and associated edema. Nephrotic syndrome in pediatric age group has been classified as either primary or secondary.
PRIMARY NEPHROTIC SYNDROME
The diseases in this case originates in the kidney and is limited only to this organ and are largely idiopathic which may be of the following three types:-
1. MINIMAL CHANGE DISEASE:In this case the damage to the glomeruli is only at the electron microscopic level. This is the most common cause of nephrotic syndrome in children.
2. FOCAL SEGMENTAL GLOMERULOSCLEROSIS:Damage to the glomeruli occurs at some of the focal points.
3. MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS:In this case the immune system attacks the glomeruli causing damage by the deposition of antibodies in the glomeruli. This is the most common cause in adults.The above three types equally affect adults as it does in children.
SECONDARY NEPHROTIC SYNDROME
This syndrome occurs secondary to other diseases.
CAUSES OF NEPHROTIC SYNDROME IN CHILDREN
It may occur secondary to diabetes, H.S.purpura, Hepatitis, malaria and streptococcal infection etc.Nephrotic syndrome may also occur congenitally in a few cases.
DIAGNOSIS & INVESTIGATIONS
The confirmatory diagnosis of nephrotic syndrome is based on the presence of heavy proteins in urine, low serum albumin levels and hyperlipidemia.
FOR THE DETECTION OF THESE VALUES THE FOLLOWING TESTS ARE RECOMMENDED-
Urine protein >3 gm in 24 hrs is confirmatory.
Complete blood count
Urinanalysis.
Creatinine levels in the blood and urine.
Serum albumin levels
Lipid profile- suggesting hyperlipidemia.
Kidney biopsy – in case of idiopathic nephrotic syndrome.
Dip stick test of urine is done as an initial investigation to confirm the presence of proteins in urine.
PROGNOSIS
It varies from person to person and associated pathological conditions. Ayurvedic formulations have shown tremendous results in managing nephrotic syndrome. The detailed account of some of the herbs used and other related details is as follows.
Herbs for NEPHROTIC SYNDROME
The cause of disease in Ayurveda is the imbalance in the dosha, dhatu and mala which may occur due to numerous factors.
SOME OF THE HERBS USEFUL IN THE MANAGEMENT OF NEPHROTIC SYNDROME ARE:
Punarnava (Boerrhavia diffusa)
Rakta chandana (Pterocarpus santalinus)
Gokshur (Tribulus terrestris)
Turmeric (Curcuma longa)
Guggulu (Commiphora mukul)
PLANTBASED AYURVEDA’S HERBAL SUPPLEMENTS FOR GOUT MANAGEMENT
IT HAS THE FOLLOWING CONTENTS, THE DETAILS AND SPECIFICATIONS ARE MENTIONED BELOW-
1. PHYLLANTHUS NIRURI
It is an excellent herb for the management of gall bladder stones or cystic stones. It stimulates the appetite thereby improving nutrition levels of the body. It also stimulates the liver functions which helps in detoxifying the body and eliminating accumulated toxins in the body. All parts of this plant are used as herbal suppliments. It has a cooling effect which eases dysuria in case of Nephrotic syndrome. Planet Ayurveda’s PHYLLANTHUS CAPSULES have the best standardized extracts of Chanca piedra and show great results when taken under proper management guidelines.
DOSE
2 Capsules twice daily with warm water after meals or as recommended by the ayurvedic physician.
In children – 1 capsule, once daily or as directed by the physician.
2. CURCUMIN CAPSULES
Turmeric (Curcuma longa) is a flowering plant which is a very common kitchen essential. It is also used as a potent ayurvedic herb in managing many disease conditions. In case of Nephrotic syndrome it is used to suppress nephritis in the damaged areas of the kidneys as turmeric is a good anti-inflammatory herb. Turmeric also has tremendous relieving properties as is evident from its wide use in the management of skin diseases. For this same action it is found very beneficial in managing glomerulonephritis in patients of nephrotic syndrome. It also helps balance all the three doshas i.e. vata, pitta and kapha restoring health in diseased condition.Curcumin capsules are made from 100% standardized extracts and show best desired results in most patients.
DOSE:
2 Capsules two times a day with warm water after meals.
In children- 1 capsule, once daily or as directed by the physician.
3. CHANDANADI VATI
It is a potent diuretic and has urine cleansing properties. Ingredients like safed chandana, kankola, amlaki ang berberis extracts are all good diuretics and are combined in chanadanadi vati tablets to provide effective diuresis and prevents the kidney from getting infected due to urine stasis. Apart from this, it has remarkable relieving properties which help in balancing all the three doshas (especially kapha and pitta) and cleansing of all the srotasas which in itself helps in managing any disease. It strengthens the renal system and is a great renal tonic. Besides nehrotic syndrome it is also used in other renal disorders, urinary tract infections and uterine disorders.
INGREDIENTS
Safed Chandan powder (Santalum album)
Kankola (Piper cubeba)
Safed Ral (Vateria indica)
Gandhabiroja (Ferula galbaniflua)
Khadira (Acacia catechu)
Amalki (Emblica officianalis)
Karpur (Cinnamomum camphora)
Rasaut (Berberis extract)
Gairik (Iron salt)
Pashanbhed (Berginia ligulata)
Gokshur (Tribulus terrestris)
Sukshma Ela (Elletaria cardamomum)
DOSE
2 tablets three times daily with warm water, to be taken after meals or as directed by the physician.
In children- 1 tablet twice daily for kids.
4. MUTRAKRICHHANTAKA CHURNA
It is a unique combination of diuretic and anti-inflammatory herbs which collectively help in managing urinary tract infections, ureteric stones and painful micturition. In addition to it this combination has an antimicrobial action as well which prevents and relieves any kind of microbial infestation that may occur associated with the diseases of the kidney.
INGREDIENTS
Varun (Crateva nurvala)
Bhumi amla (Phyllanthus niruri)
Gokshur (Tribulus terrestris)
Kalmegh (Andrographis paniculata)
DOSE – 1 Teaspoonful twice daily with warm water and for best result Boil 1 Teaspoonful in 400ml water until it remains 50-60ml. Filter the preparation with a regular tea strainer and drink. You should use this once in morning 45min. after breakfast and similarly in evening 45min. after dinner. Prepare fresh every time as per this.The powder can be made into a decoction by boiling 1 tsf powder in 400 ml water until it remains 50 ml. When luke warm, it can be consumed similarly.
EFFECTIVE HERBS AND HERBAL SUPPLEMENTS TO MANAGE NEPHROTIC SYNDROME
S.No. | Products | Quantity |
1 | Mutrakrichantak Churna | 1 pack (200gm) |
2 | Curcumin Capsules | 2 Bottles (120 Capsules) |
3 | Chandanadi Vati | 2 Bottles (240 Tablets) |
4 | Phyllanthus Niruri | 2 Bottles (120 Capsules) |
PRODUCT QUANTITY IS AS PER DOSAGE REQUIRED BY ADULTS – FOR PATIENTS UNDER AGE 14 – THIS QUANTITY WILL LAST FOR 2 MONTHS
It is a renal disorder characterized by a set of signs and symptoms such as the passage of heavy amounts of proteins in urine (>3.5 gm per day) along with hypoalbuminemia and associated edema which may be generalized anasarca or it may be limited locally.