The Aetiopathological Study of Chronic Renal Failure with Ayurveda Perspective

Abstract

Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiologic processes associated with abnormal kidney function, and a progressive decline in glomerular filtration rate (GFR). Provides a widely accepted classification, based on recent guidelines of the National Kidney Foundation {Kidney Dialysis Outcome Quality Initiative (KDOQI)}, in which stages of CKD are defined according to the estimated GFR. The term Chronic Renal Failure applies to the process of continuing significant irreversible reduction in nephron number, and typically corresponds to CKD stages 3-5. The pathophysiologic processes and adaptations associated with chronic renal failure will be the focus. The dispiriting term end-stage renal disease represents a stage of CKD where the accumulation of toxins, fluid, and electrolytes normally excreted by the kidneys results in the uremic syndrome. This syndrome leads to death unless the toxins are removed by renal replacement therapy, using dialysis or kidney transplantation. It is important to identify factors that precipitate risk for CKD, even in individuals with normal GFR. Risk factors include hypertension, diabetes mellitus, autoimmune diseases, and older age, a family history of renal disease, a previous episode of acute renal failure, and the presence of proteinuria, abnormal urinary sediment, or structural abnormalities of the urinary tract. CKD not only increases the mortality and morbidity due to its vascular complications resulting in cardiovascular-cerebrovascular events and CKD progression to end-stage kidney failure; but also because of its adverse impact on the economy of the country. This is now almost a global phenomenon and not restricted to India alone. Considering that prevalence of CKD in India is noted to be 13.8% which itself is very high; early detection, evaluation and preventive management will be the key to delay progression and to prevent adverse outcomes. In India ~ 90% patients cannot afford the cost.