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ARF is defined as the potentially reversible, rapid decline in the excretory function of the kidney which develops over hours to days leading to retention of nitrogenous waste products and the consequent clinical conditions.

So in kidney failure the filtering capacity of kidney is lost and there is the accumulation of waste products in the blood.

Symptoms

  • Oliguria-decreased urine output

  • Patient commonly presents with symptoms related to hypovolemia, including thirst, dizziness and orthostatic hypotension.

  • Fatigue

  • Nausea

  • Swelling of feet and ankle

  • Evidence of excessive fluid lost through GI tract, hemorrhage. Sweating or renal loss may be present. In advanced cases, the patient may have cardiac arrest.

Investigation

1. Urine analysis

2-Complete blood cell count and peripheral smear

3- Blood urea and serum creatinine

4-Urinary electrolytes

5- Ultrasound examinations

6- Serological test

Treatment

General measures

Restrict fluid intake

Avoid salt and salted items

Intake of sodium, potassium, and protein should be restricted

Daily recording of-

  • Fluid intake

  • Urine output

  • Blood pressure

  • Body weight

  • Blood urea

  • Serum electrolytes

In severe cases, dialysis is necessary, and it depends upon the condition of the patient and the blood level of potassium and creatinine values.

Homeopathic treatment

Treatment should be hospital based because frequent checking of urine output, blood pressure, and Serum creatinine is needed. Moreover fluid intake and urine output ratio chart should be maintained. Since it being an acute complaint symptomatic management is the rule. For these present symptoms and some physical symptoms like thirst, desires and aversions, are taken. Usual medicines are Apis, Digitalis, Zingiber, Ars alb, etc.

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URINARY TRACT INFECTION


UTI is the presence of microbial pathogens in the normally sterile urinary tract. The bacteria which are mostly involved in the UTI are E. Coli, Staphylococcus epidermidis, Proteus, etc.

The factors associated with UTI are

  • bacterial virulence  host defense, which includes colonization of the vagina and mucosa

  • acquired factors include antimicrobials, sexual intercourse and ageing.

Clinical features

1) ACUTE CYSTITIS

It is associated with

  • frequency

  • urgency

  • dysuria.

  • urine appears hazy and offensive.

2) ACUTE NEPHRITIS

It includes-

  • dysuria

  • urethral discharge.

3) ASYMPTOMATIC UTI

Significant bacteriuria is often not associated with symptoms and does not require treatment except in the pregnant women.

Treatment

Plenty of fluid intakes are needed to get rid of the infection.

Homeopathic treatment

Homeopathic medicines cure completely both the acute as well as the chronic urinary tract infection irrespective of the causative factor or causative organism.

Medicines like Apis, Cantharis, Merc sol, Terebinth, etc. is the medicines for acute episodes.

Medicines chosen according to physical and mental peculiarities of the patient are given in chronic cases. As seen in clinical practice, chronic cases can be prevented if constitutional medicines are selected as per the homeopathic philosophy.

ACUTE NEPHRITIC SYNDROME

Acute nephritic syndrome is characterized by haematuria, red blood cell cast in urine, proteinuria, oliguria (decreased urine output), hypertension, fluid retention and sometimes renal failure.

Common causes

  • Post streptococcal acute glomerulonephritis

  • Other post infective acute nephritic syndromes following staphylococcal are, pneumococcal and viral infections.

  • Focal glomerulonephritis and membranoproliferative glomerulonephritis.

  • Collagen disorders, especially SLE, and poly arthritis nodosa

  • Miscellaneous groups: henoch scholien syndrome, infective endocarditis, hemolytic uremic syndrome, and early stages of good pasture's syndrome.

Clinical features

Mainly due to post streptococcal glomerulonephritis.

The illness starts about 2-3 weeks after streptococcal bacterial infection on the skin, throat or respiratory tract. It is more common in children but can occur at any age. Both sexes are affected. The onset is often abrupt with puffiness of face, reduced output of urine and reddish smoky urine, hypertension and edema. Severity of the disease is variable. Mild cases may go unnoticed. Severe cases present acutely with life-threatening complications like hypertensive encephalopathy, acute left ventricular failure or uremia. Majority of cases of post streptococcal glomerulonephritis in children is self-limited, and more than 90% recover completely without complication or sequale. After a week or so of the oliguric phase, the diuresis starts.

Homeopathic treatment

Since the majority of the causes due to streptococcal bacterial infection treatment is aimed to treat from the source itself. If the correct medicine according to the present acute symptomatology is given, the complication of acute nephritic syndrome can be very well prevented. But once the acute nephritic syndrome starts hospital admission is necessary because the flout intake should be controlled, and the output of urine should be measured and compared to the input of fluid, and moreover, blood pressure should be measured every now and then.

But in that situation also if homeopathic medicines are tried the recovery will be fast. So homeopathic medicine is effective for the treatment as well as the preventive aspect also.

The homeopathic medicines usually given for the streptococcal infections are Psorinum, Sulphur, Streptococcinum, etc.

If acute nephritic syndrome starts medicines like Apis, Zingiber, Ars alb, Puls, Merc Sol etc. can be tried.

For treatment and further queries

                  ACUTE NEPHRITIC SYNDROME

 Acute nephritic syndrome is characterized by haematuria, red blood cell cast in urine, proteinuria, oliguria (decreased urine output), hypertension, fluid retention and sometimes renal failure.

Common causes

X   Post streptococcal acute glomerulonephritis

X   Other post infective acute nephritic syndromes following staphylococcal are, pneumococcal and viral infections.

X   Focal glomerulonephritis and membranoproliferative glomerulonephritis.

X    Collagen disorders, especially SLE, and poly arthritis nodosa

X   Miscellaneous groups: henoch scholien syndrome, infective endocarditis, hemolytic uremic syndrome, and early stages of good pasture's syndrome.

Clinical features

Mainly due to post streptococcal glomerulonephritis.

   The illness starts about 2-3 weeks after streptococcal bacterial infection on the skin, throat or respiratory tract. It is more common in children but can occur at any age. Both sexes are affected. The onset is often abrupt with puffiness of face, reduced output of urine and reddish smoky urine, hypertension and edema. Severity of the disease is variable. Mild cases may go unnoticed. Severe cases present acutely with life-threatening complications like hypertensive encephalopathy, acute left ventricular failure or uremia. Majority of cases of post streptococcal glomerulonephritis in children is self-limited, and more than 90% recover completely without complication or sequale. After a week or so of the oliguric phase, the diuresis starts.

Homeopathic treatment

Since the majority of the causes due to streptococcal bacterial infection treatment is aimed to treat from the source itself. If the correct medicine according to the present acute symptomatology is given, the complication of acute nephritic syndrome can be very well prevented. But once the acute nephritic syndrome starts hospital admission is necessary because the flout intake should be controlled, and the output of urine should be measured and compared to the input of fluid, and moreover, blood pressure should be measured every now and then.

But in that situation also if homeopathic medicines are tried the recovery will be fast. So homeopathic medicine is effective for the treatment as well as the preventive aspect also.

The homeopathic medicines usually given for the streptococcal infections are Psorinum, Sulphur, Streptococcinum, etc.

If acute nephritic syndrome starts medicines like Apis, Zingiber, Ars alb, Puls, Merc Sol etc. can be tried.

For treatment and further queries

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BENIGN PROSTATIC HYPERTROPHY

Non neoplastic tumor like enlargement of the prostate termed as benign nodular hyperplasia or benign enlargement of the prostate is a very common condition in men. Symptomatic BPH produce urinary tract obstruction.

After 40, prostate began to increase in volume by 2.4cm yearly on average. 50 % of men after 80 develop lower urinary tract infection.

Etiology

Cause of BPH is not fully established. Few etiological factors such as endocrinologic, racial, inflammation and arteriosclerosis have been more fully investigated and considered as a strong possibility.

Clinical features

The basic symptoms are due to the obstruction to the urethra by prostate. Frequency, hesitancy and urgency are the main triad of symptoms. Narrow and prolonged stream, sensation of incomplete emptying are also associated with BPH. But urge incontinence is not specific. 

Sometime patient develops sudden retention of urine, so cannot urinate, which result in painful distended bladder. Excessive intake of alcohol, constipation, and prostatic infection may precipitate this.

In long standing cases, the bladder gradually distends and becomes a pain-free distended bladder which in the long run cause's hydroureter, hydronephrosis, and renal failure.

Symptomatic cases develop due to complications such as urethral affection, secondary effects upon the bladder, ureters and kidneys. The other presenting features include frequency, nocturia, difficulty in micturition, pain, haematuria and sometimes the patients present with acute, retention of urine requiring immediate catheterization.

Investigations

Determination of prostate volume by rectal examinations.

Flow rate of urine by flow meter.

U S G also to determine prostate volume.

Estimation of PSA-Prostate-specific antigen is a good tumor marker to rule out prostate cancer.

Treatment-effective homeopathic treatment for grade one and grade two types.

But grade in three type enlargement only temporary relief for the symptoms will be there.

But if homeopathic treatment is started from the beginning further enlargement of the prostate, and the following worsening of symptoms can be definitely prevented. Moreover, the PSA level if increased can also bring back to normal.

Medicines- Sabel serr Q, Solidago Q, Thuja, Conium Mac, 

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CANCER OF BLADDER

Bladder tumors arise from the lining of the bladder, in continuity with the epithelial lining of the renal pelvis, ureter and the major part of the urethra.

Etiology

  1. INDUSTRIAL OCCUPATIONS

Workers in industries that produce aniline dyes, rubber, plastic, textiles, and cable have high incidence of bladder cancer.

  1. SCHISTOSOMIASIS

 The patients having bilharziasis infestation of the bladder.

  1. DIETARY FACTORS

The artificial sweeteners like saccharin, coffee or caffeine and chronic alcoholism.

  1. LOCAL LESIONS

These include leukoplakia of the bladder mucosa, vesical diverticulum.

   5) SMOKING

   6) DRUGS

Risk factors

  • Smoking

  • Males are commonly affected.

  • Old age

  • Exposure to dyes like arsenic, and chemicals used to manufacture dyes, leather, rubber, etc.

Symptoms

  • Usually affect the old people, but can occur in younger age also.

  • Frequent and painful urination, painless haematuria

  • Pelvic mass

  • Swelling in lower legs 

  • And general symptoms like anemia and weight loss

Treatment

Based on the symptoms and also based on constitutional as well as miasmatic background a deep acting remedy prescribed. Homeopathic medicine can be tried after radiation or after chemotherapy or even after surgery. It can also be given along with allopathic medicine.

Usually indicated medicines are -

 Bacil, Lachesis, Thuja, Syphyllinum, Terebinth, etc.

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HAEMATURIA

Haematuria is the bleeding from anywhere in the renal tract. Urine microscopy is valuable in establishing the cause of bleeding. The presence of white blood cells and organisms may suggest infection; the presence of red cell casts indicates the glomerular bleeding. High portions of dysmorphic erythrocytes, likewise, support the glomerular bleeding.

Haematuria may be microscopic or visible. True positive results may occur during menstruation, infection or strenuous exercise. Visible haematuria (macroscopic) most probably may be due to tumours.

Although it gives warning of renal disease, it is commonly caused by usual benign condition of thin GBM (Glomerular basement membrane) disease, insignificant vascular malformation, renal cyst or renal stones.

Causes of red or dark urine

1. Haematuria

2. Hemoglobinuria: red urine, stick test for blood positive but no red cells in microscopy.

3. Myoglobinuria: in rhabdomyolysis, urine is dark or black urine. Stick test for blood is positive. But no red cells in microscopy

4. Food dyes like beetroot.

5. Drugs:Phenolphthaliene,Senna Senna, Levodopa,  Rifampicin

6. Porphyria

7. Alkaptonuria

Causes of haematuria

1. Tumors of the ureter

2. Cystitis

3. Trauma to the ureter

4. Renal cyst

5. Vascular malformation

6. Glomerular disease: inflammatory and degenerative

7. Interstitial disease

8. Infarction

9. Clotting disorder

Homeopathic treatment

Homeopathic medicines are effective not only to control the haematuria but also to cure the haematuria. Homeopathic medicine changes according to the causes of haematuria. For example, if the cause is due to trauma, the medicine is Arnica. And if it is due to clotting disorder of blood, then the medicine is Lachesis and Phosphorus. In short homeopathic medicines can be advocated in the treatment of haematuria. Other medicines like Apis, Terebinth, Ipecac, etc. can be given according to the cause as well as the nature of the disease.

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NOCTURIA

Nocturia is the excessive urination at night. It may result from excessive fluid intake at night, or prostatic enlargement, or chronic kidney disease. It may also occur in sleep without functional abnormalities of urinary tract.

Causes

The most common cause is urinary tract infection.

Enlargement of the prostate gland, or infection of the prostate gland

Diabetes mellitus

Anxiety

Sleeplessness

Bladder tumor, prostatic tumor, or tumor in the pelvic area

Prolapse bladder

Parkinson’s disease

Treatment-

If it is due to excess fluid intake, regulate its intake after evening hours. 

Homeopathic medicine will control and cure the nocturia. For this, the cause behind nocturia should be diagnosed. If it is due to prostatic enlargement, or if it is due to kidney disease organ specific remedies like Sabel serr, Solidago, Conium mac, Apis, Lyco, etc. can be selected.

In children heredity and psychological factors are there for nocturia. And in the majority of the cases, no definite pathology will be found. In such cases homeopathic medicines like, Nat mur, Causticum, Sepia, Cina, etc. are the best remedies.

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PROTEINURIA

 Normally, urine may contain up to 150 mg of protein in 24 hours. In the health two-thirds of urinary protein is constituted by protein of tubular origin, particularly tamm horsfall mucoprotein. Protein derived from plasma namely albumin, immunoglobulin, light chain and beta2 microglobulin constitutes the remaining. Albumin may constitute 10 mg in 24 hrs .In glomerular disease proportion of albumin loss in the urine increases. Proteinuria may result from renal disorders, lesion in urinary tract or extra renal causes like cardiac and fever. A globulin -albumin ratio of <0.1% suggest highly selective proteinuria.

Gross Proteinuria above 3. 5mg in 24 hours occurs in nephrotic syndrome. In about 50% patients with multiple myeloma, light chain of immunoglobulin called bence Jones protein is detected in urine. It may also be seen in other conditions like macroglobulinemia, lymphoma leukemia, amyloidosis and other malignancies. 

Some terms

  • Fixed Proteinuria: >1g/24 hours, mostly of glomerular origin and mainly albumin.

  • Overflow Proteinuria: light chain of myeloma.

  • Tubular Proteinuria: <1g/24 hours, mostly protein other than albumin.

  • Orthostatic Proteinuria: this occurs only when the patient assumes erect posture.

  • Physiological Proteinuria: this may occur transiently even in normal persons after heavy exertions.

In many types of renal diseases, the severity of Proteinuria is a marker for increased risk of progressive loss of renal function.

Homeopathic treatment.

Homeopathic medicines are highly effective for the treatment of Proteinuria. 

Homeopathic medicines like Merc Sol, Lycopodium, Apis, etc. are some among them

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                           CARCINOMA OF PROSTATE

                (CA PROSTATE)

Cancer of the prostate is the second most common cancer in males, and it is seen after the age of 50 years.

Metastatic spread to lymph node occurs early and also metastasis to bone, mainly lumbar spine, and pelvis.

CLASSIFICATION 

1) Latent CA

2) Incidental CA

3) Occult CA

4) Clinical CA

Etiology

  1. endocrinological factors:

The hormone androgens are considered for the development and maintenance of the prostatic epithelium. Role of androgen is supported by the following indirect evidence.

   a)  Orchidectomy (removal of testes) prevents spread and growth

   b) Administration of estrogen causes regression of CA prostate.

2) Racial and geographic influences:

   It is uncommon in Japanese and Chinese and high in Americans.

3) Environmental influences

  This includes high dietary fat, exposure to chemicals like polycyclic aromatic hydrocarbons.

4) Nodular hyperplasia

5) Heredity

SPREAD

1) Direct extension occurs into the prostatic capsule and beyond.

2) Metastasis: distance spread by both lymphatic and hematogenous route.

Clinical features:

  • On palpation: hard nodular gland fixed to the surrounding tissue.

  • Urinary obstruction with dysuria, frequency, retention of urine, haematuria, pain in back due to skeletal metastasis

STAGING CLINICAL

  • Stage 1:

Tumour found incidentally or clinically unsuspected CA in prostate removed for benign disorder.

  • Stage 2

Tumour palpable by rectal digital examination but confined to the prostate.

  • Stage 3

Tumour has extended locally beyond the prostate into the surrounding tissues.

  • Stage 4

Tumour with metastasis to other sites.

Investigation.

USG

Plain X ray lumbar spine and pelvis to rule out metastasis

Radio isotope bone scans to know distant metastasis.

Estimation of PSA (PROSTATIC SPECIFIC ANTIGEN) - value more than 100ng/ml indicates distant bone metastasis.


Homeopathic treatment

Homeopathy definitely has a role in the treatment of cancer. It can be tried as itself or along with the ongoing system of treatment. Since the action of medicine is in a different plane, its action will not be hindered by the action of other systems of medicine.

As usual, the mental as well as the physical aspect of the patient is collected and the family history and if any impacts in mental level are considered before selecting the homeopathic remedy. In general, the over whole prognosis is good and homeopathic medicines can be tried along with other systems of medicine. In clinical practice symptomatic, improvement is fast and permanent.

HOMEOPATHIC MEDICINES like Thuja, conium mac, Hydrastis Q can be tried. But only under the guidance of a doctor .

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                               PYELONEPHRITIS

It is the inflammation of the kidney.

ACUTE PYELONEPHRITIS

It is the acute inflammation of the ureter and the adjoining part of renal parenchyma and is caused by bacteria B. coli.

The triad of symptoms like loin pain, fever, and tenderness over the kidney is the key features.

Symptoms

1) Frequency and urgency of urination.

2) There will be burning sensation during urination.

3) Dysuria.

4) Strangury

5) Temperature with chill and rigor, which comes down with sweating.

6) Pain in the loin due to stretching of the renal capsule and in the lower abdomen due to associated cystitis.

Investigations

1) Blood

2) Urine examination

3) Immunofluorescence study of urinary bacteria

4) Urine culture

Treatment 

Drinking plenty of water is the first treatment. At least 2 to 3 liters of water per day will help not only for the cure but also as a preventive of infection.

Homeopathic treatment

Acute episodes are treated by the present symptomatology, and some diseases are also considered. Homeopathic medicines like Apis, Sarasaparilla, Uva ursi, Cantharis, Terebinth, etc. are very effective.

To prevent the recurrence and the chronic pyelonephritis the medicines are selected according to the homeopathic principle. Homeopathic medicines are found to be very effective to prevent the chronic pyelonephritis.

Here the medicines like Lycopodium, Lachesis, Ars alb, Medorrhinum etc. are usually prescribed according to the individual in treatment,

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RENAL COLIC

Renal colic is the acute loin pain radiating to the groin with haematuria.

Nephrolithiasis or urolithiasis is the formation of urinary calculi at any level of urinary tract.

Renal calculi are the aggregate of crystals containing a small amount of proteins, and glycoproteins. Dietary, genetic and environmental factors are responsible for it.

Majority of the stones are calcium oxalate and phosphate stones. Uric acid stones are also there. Some drugs may also form stones-(eg; ephidrin)

The size may vary from sand like particles to large round stones in bladder and staghorn calculi that fill the whole renal pelvis and branches into calyces. 

Predisposing factors

Dietary factors

  • High environmental temperature, low fluid intake

  • High-protein diet, low calcium and high sodium

  • High sodium excretion

Acquired causes

Hypercalcemia (high calcium level in blood)

Inherited causes

Cystinuria, familial hypercalciuria

Symptoms-

  • Sudden attack of pain-which starts from the flank to groin and also it extent to testes or labium (in females). Pain increases suddenly and reaches to the maximum within minutes.

  • The patient is highly restless; continuously walk around, sweating vomiting and pallor. 

  • Frequency, dysuria, haematuria may occur. 

  • The severe pain may subside by about two hours, but mild pain persists for days. 

TYPES OF URINARY CALCULI

There are mainly four types of urinary calculi.

  1. Calcium stones.

   They are the most common of all urinary calculi and may be the pure stones of calcium oxalate or calcium phosphate or a mixture of calcium oxalate and calcium phosphate.

  1. Mixed (struvite) stones.

They are made up of magnesium -ammonium-calcium phosphate. It is often called as struvite or triple phosphate stones.

  1. Uric acid stones:

  Uric acid stones are radiolucent and are frequently found in cases with hyperuricemia and hyperuricosuria such as primary gout or secondary gout, chemotherapy.

  1. Cystine stones:

They are associated with Cystinuria due to a genetically determined defect in the transport of cystine and other amino acid across the cell membrane of the renal tubules and small intestinal mucosa.

  1. Other calculi:

Due to inherited abnormality of enzyme metabolism

Investigations- 

x ray abdomen.

Ultrasound abdomen

IVU

Spiral CT the most accurate assessment, and help to diagnosis opaque stone like uric acid stone. 

Urine- routine examination

Treatment-

Drink plenty of fluids. At least three to four glasses of water should be taken per day.

Homeopathic medicines definitely have a role in the treatment of renal colic and for the expulsion of renal calculus. 

Acute episodes of renal colic can be controlled by medicines like Lycopodium, Nux vom, Cantharis, etc. the selection of medicine in acute pain depends upon the side of affection, nature of pain, and with accompanying symptoms like nausea vomiting, urging to urinate or defecate, etc.

To expel the calculus homeopathic medicines are chosen according to the site of affection, chronicity of the complaint, previous history of the patient, nature of the stones, etc. once the calculus is expelled unlike other systems of medicine, there will be no formation of calculus again and again.

Calculus up to the size of 8mm can be expelled by homeopathic medicines.

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NEPHROTIC SYNDROME

Nephrotic syndrome is the disease of kidney and is characterized by -

1-Heavy Proteinuria of >3.5g/1.73 5g/1.73 m square body surface area in 24 hours,

2-Hypoalbuminemia (decreased level of albumin in blood)

3-Oedema

3-Increased level of cholesterol 

4-Hypercoagulable state of blood.

Etiology

a) Primary glomerular disease (idiopathic NS)

    1. MINIMAL CHANGE DISEASE

    2. FOCAL SEGMENTAL GLOMERULOSCLEROSIS

    3. MEMBRANOUS NEPHROPATHY

    4. MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS

    5. MESANGIOPROLIFERATIVE GLOMERULONEPHRITIS

    6. IgA NEPHROPATHY

b) Secondary nephrotic syndrome

1. Infection

2. Neoplasm

3. Drugs

4. Multi system disease

5. Heredofamilial and metabolic disease.

Features of the nephrotic syndrome

Both, children as well as adults are affected. It can occur at any age, and males are affected more than the females.   

Hypoalbuminemia is a cardinal feature of NS. This is due to urinary loss of albumin. Several other plasma proteins are also lost in urine.

Symptoms of nephrotic syndrome

  • Generalized oedema and facial puffiness are the cardinal symptoms of nephrotic syndrome.

  • Effusion into serous cavities. Severity of oedema depends upon the severity of Proteinuria, duration and type of disease, dose of diuretics, etc.

Oedema first appears below the eyes and face, especially in the morning while waking up and appears on the lower leg and ankles by evening.

  •  Oliguria (decreased urine output) - due to renal hypoperfusion is common, especially in the acute phase. 

  • Hyperlipidemia is common in NS.

  • Fatigue and weakness and patient look pale.

  • High blood pressure-all the patients with nephrotic syndrome will have increased blood pressure.

Diet to be followed

Strict diet regulations should be followed as per the advice of the consulting doctor. Generally reduce salt and salted items,

Avoid sodium rich foods like celery, carrots, turnips and-

Canned foods, pickles, pastry, fast foods biscuits. 

To compensate for the protein loss extra protein foods can be supplemented as per doctor’s advice.

Homeopathic treatment

In clinical experience, it is found that homeopathic medicines are highly effective for the treatment of nephrotic syndrome, and allopathic medicines won’t alone complete the cure. Moreover, there are complications for the conventional treatment.

Homeopathic medicines are highly effective to stop the proteinuria, controlling the oedema, and also it increases the hemoglobin count in the blood and there is a marked improvement in the general health of the patient.

The duration of the homeopathic treatment depends on the chronicity of the disease; extend of kidney damage, the severity of the symptoms, underlying disease conditions and also the general health of the patient.

Medicines usually indicated are-

Apis, Lycopodium, Eel serum, Digitalis, Lachesis, etc.

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