Homoeopathy in chronic renal failure

PRESENTATION BY: DR. BIPIN JETHANIAssistant Professor, Department of Organon of

Medicine,Nehru Homoeopathic Medical College & Hospital,

New Delhi.E-mail: drbipin.jethani@gmail.com

Scope of homoeopathy in

chronic renal failure

HOMOEOPATHIC APPROACH IN CASES OF CHRONIC RENAL

FAILURE

SCOPE OF HOMOEOPATHY IN CRF

In cases of CRF, homoeopathic treatment can help to

improve patient’s quality of life through relief of

troublesome symptoms, limit renal damage and preserve existing renal functioning as

well as prevent complications.

MY EXPERIENCES IN CASES OF

CHRONIC RENAL

FAILURE

Cases of grade 4-5 ckd treated

with homoeopathy

CASE OF CRF (grade 5 CKD) WITH DM/ CAD

A 68 yr. old female with mesomorphic build (wt. =75 kg.) and mole on left cheek reported with c/o recurrent dyspnoea during sleep (PND) with extreme exhaustion and swelling around the lower eyelids.

PRESENTING COMPLAINTS

• Inspite of extreme weakness, she never liked to rest and badly missed her ‘morning walks’.• Appetite was much reduced.• Occasional cough especially in winters.• Had tendency to evening rise of temperature, with malaise and slight nausea.

PHYSICAL GENERALS

• Chilly patient• Thirst for very cold water ---

almost chilled.• Desire for very cold water and

extremely warm food.• Desire for salty foods• Tendency to increased

Perspiration especially in axilla region.

• Sleep; disturbed, unrefreshing.• Occasional tendency to loose

stool.

EVOLUTIONARY STUDY OF PATIENT

• Strong family history of Pulmonary koch.• H/o severe attack of measles at age of 8 years.• h/o tonsillectomy at age of 12 years.• Recurrent history of acute bronchitis in childhood.• h/o appendicectomy at age of 35 years

FIRST prescription – PHOS. 0/1

• Keeping in view, desire for chilled water and salty food with Tubercular background, I started with PHOSPHOROUS in LM POTENCIES but it did not help.

PRESCRIBING CLUE – IMPORTANCE OF SOIL

• The STRONG TUBERCULAR FAMILIAL BACKGROUND AND TUBERCULAR TAINT (RESTLESSNESS WITH EMACIATION, DESIRE FOR EXTREMES TEMPERATURE FOOD & EVENING RISE OF TEMPERATURE) WITH H/O CRF LED ME TO PRESCRIPTION OF :

KOCH LYMPH

KOCH LYMPH WAS PRESCRIBED IN LM POTENCY

KOCH’S LYMPH

Acute and chronic parenchymatous nephritis; produces pneumonia, broncho-pneumonia, and congestion of the lungs in tuberculous patients, and is a remarkably efficacious remedy in lobular pneumonia-broncho-pneumonia.

REF.: TUBERCULINUM in ‘HOMŒOPATHIC MATERIA MEDICA’ by William BOERICKE

KOCH’S LYMPH

It is especially useful in cases of family history or

personal history of tuberculosis or strong

tubercular diathesis with renal involvement.

MARKED SYMPTOMATIC AND BIOCHEMICAL IMPROVEMENT

PRE-TREATMENT POST TREATMENT

CREATININE LEVELS REDUCED FROM 7.6 T0 5.73 mg%

The patient could reduce the frequency of dialysis from thrice a week to twice a week and most importantly, her creatinine levels reduced and she is now clinically GRADE 4 CKD.

A CASE OF CHRONIC kidney disease(ckd grADE 4)

A 45 yrs. male patient of GRADE 4 CKD reported in NHMC OPD with high creatinine levels (4.5 mg%) with hypertension. He was infact incidentally diagnosed because when he had gone for check up of his mother, he too thought of getting BP measured. He had no significant ailment except recurrent tendency to retrosternal burning and slight itching.

A CASE OF CHRONIC RENAL FAILURE

Further follow-up investigations revealed CRF with high creatinine levels 4.1 mg%); much to the surprise of patient who was otherwise FEELING QUITE WELL.

His anamnesis revealed that he had recurrent h/o fever with sore throat and coryza since childhood for which he had taken lots of antibiotic treatment. Further he had EXERTIVE NATURE OF WORK – he was at managerial post in restaurant which compelled prolonged physical exertion.

PHYSICAL GENERALS

• Thirst much decreased • Appetite good; craved rich

food• Tongue thick coated, with

superficial cracks.• Perspiration on forehead

especially during fevers.• Slightly chilly patient.

A CASE OF CHRONIC RENAL FAILURE

Says there is nothing the matter with him.

ARNICA MONTANA

GOOD APPETITE IN GRADE 4 CKD ----- FEELING WELL IN DANGEROUS CASES

H/O PROLONGED PHYSICAL EXERTION

Arnica montana in case of CRF

• PATIENT showed marked improvement (both clinical and symptomatic)with ARNICA MONTANA PRESCRIBED IN LM POTENCY. The creatinine levels improved to 2.8 mg% and the patient could avoid dialysis.

KNOWN CASE OF CRF (Grade 5 CKD) WITH DM, H/T AND CAD

A dark complexioned 48 year old male patient with lean build (wt.51 kg.) reported with c/o gradual loss of appetite with excessive tiredness, nausea and vomiting after each meal.

PRESENTING COMPLAINTS:

• ABSOLUTE LOSS OF APPETITE.

• TENDENCY TO pitting swelling of feet especially after long journey

• EXTREME WEAKNESS, DIFFICULTY EVEN TO PERFORM HIS DAILY CHORES.

• Tendency to constipation; stool passed with great straining.

• Increased CHILLINESS SINCE LAST 1 YEAR (DAIGNOSED AS CRF).

LIFE SPACE & ANAMNESIS

• He was eldest son in the family. Has been pursuing business (Home interiors) since 18 years.

• Has been a hard worker and has put in lots of efforts to build his business.

• H/O recurrent itching with annular lesions on chest and abdomen (?taenia corporis) in winters.

PHYSICAL GENERALS

• Chilly patient (since childhood) – chilliness increased since

CRF

• Appetite : SIGNIFICANTLY reduced

• Perspiration: normal, more on forehead, cold sweat

especially when eating

• Sleep: normal, occasional salivation during sleep

• Thirst: normal, slightly warm water preferred

• Stool: very hard, missed often.

HAHNEMANNIAN BASIS OF

PRESCRIBING

‘The internal essential nature of every malady, of every individual case of disease, as far as it is necessary for us to know it, for the purpose of curing it, expresses itself by the symptoms,

as they present themselves to the investigation of the true observer in their

whole extent, connexion and succession.’

‘THE MEDICINE OF EXPERIENCE (1805)’

ALUMINA IN CASE OF CRF

• Keeping in view the build of patient, chilliness with extreme exhaustion, costiveness and tendency to eruptions in winters, the patient was prescribed ALUMINA in LM potency.

• Subsequently, his frequency of dialysis not only decreased but his creatinine levels also came down with marked symptomatic improvement.

PRE-TREATMENT

POST TREATMENT

CLINICAL TIPS:

China officinalis in POST DIALYSIS WEAKNESS

Considering that the process of dialysis causes sudden osmosis of large quantity of body fluids, China officinalis in LM POTENCY serves as an important remedy to be considered in cases of this debilitation from ‘LOSS OF VITAL FLUIDS’.

CUPRUM ARS.

• Cramps in calves of legs, worse after midnight, only relieved by getting out of bed and standing.

• UREMIC CONVULSIONS

• Diabetes. Urine of high specific gravity; increased, acetones and diacetic acid.

STIGMATA MAYDIS

• As a powerful diuretic in renal disorders unconnected with cardiac involvement.

• Heart and urinary conditions combined. • Suppression of urine with lack of solids

and low specific gravity.

• Has marked urinary symptoms, and has been used with success in organic heart disease, with much œdema of lower extremities and scanty urination.

SERUM ANGUILLAR ICHTHYOTOXIN & DIGITALIS IN CKD

SERUM ANGUILAR ICHTHYOTOXIN

OPHIDIA CHARACTERISTICS(clothing intolerance esp.

around neck, <: during sleep, clammy skin)

OLIGURIA HYPERTENSION

DIGITALIS

OEDEMA with abnormally slow pulse & extreme prostration

OLIGURIA HYPERTENSION