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Category: Volume 11 Issue 10 October 2023
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Title: Effective Ayurvedic Management of Steroid Resistant Nephrotic Syndrome - Case Study

Authors: Dr Sarita Pradip Gaikwad, Dr Pradip Yashwant Gaikwad

 DOI: https://dx.doi.org/10.18535/jmscr/v11i10.05

Abstract

Nephrotic syndrome presents with heavy proteinuria (3.5 g Proteins/ 1.73 m2 body surface area/24 hour), dyslipidaemia/ hypercholesterolemia, hypoalbuminema, edema and hypertension. If left untreated or undiagnosed, there is progressive damage to glomeruli causing renal failure. Heavy proteinuria is the most characteristic feature of this syndrome. Several studies have noted that higher the 24-h urine protein excretion, more rapid is the decline in GFR. It may be primary or secondary to other systemic diseases. Case study: This 2 year old male child developed Nephrotic syndrome and was placed on steroids, used to relapse when steroids are withdrawn, and subsequently developed steroid resistance. He was poorly managed by modern line of treatment for last 10 years. The case had developed Cushingoid features due to long term use of steroids. This case was successfully managed by Ayurvedic treatment principles of Deepan-Pachan, Vatalunoman and Mutral chikitsa. Steroids were withdrawn gradually and completely. There was no relapse. He was free of proteinuria. His Cushingoid features disappeared. Edema and Ascites also disappeared. This case study is the example of importance of alternative medicine in treating steroid dependent/resistant cases. When modern treatment has definite limitations to treat such cases, it is ray of hope to thousands of poor sufferers of Steroid resistant Nephrotic syndrome, finding them an effective alternative of Ayurvedic treatment.

Keywords: Nephrotic syndrome, Steroid resistance, Ayurvedic management, Dridamula Basti Shotha

References

  1. Julia B Lewis, Eric G. Neilson. Glomerular Diseases: Nephrotic syndrome. Chapter no.338 in Harrison's Principles of Internal Medicine, Vol-2. Mc Graw Hill Education 19th Edition (2015) : 1841-1842
  2. Anil K. Mandal. Nephrotic syndrome. Chapter 31 in Textbook of Nephrology. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi. 3rd  Edition (2014):349-364
  3. Ali U, Bagga A, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P, et al. Management of steroid sensitive nephrotic syndrome: Revised guidelines. Indian Pediatr 2008;45:203-14. Accessed on 21 Aug 2023.
  4. Koushal Kumar, Shalika Sharma and Nikhil Gupta. Prevalence of Different Clinical Variants of Nephrotic Syndrome in Children 1–18 Years of Age in Tertiary Care Hospital of North India. http://www.ijss-sn.com/uploads/2/0/1/5/20153321/27_ijss_jan_oa27_-_2020.pdf. Accessed on 21 Aug 2023.
  5. Chaudhry HS, Singh G. Cushing Syndrome. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470218/.
  6. Kishor Bhagwanrao Deshmukh , Sudha Singh, Nephrotic syndrome in children-An Ayurvedic approach. International Ayurvedic Medical Journal {online} 2022 {cited July 2022} Available from: http://www.iamj.in/posts/images/upload/1956_1959.pdf
  7. Ayurvedic management of Nephrotic syndrome. https://www.vedichealth.org/single-post/ayurvedic-view-of-nephrotic-syndrome#:~:text=Punarnava%20(boerhavia%20diffusa)%3A%20The,%2C%20ascites%2C%20and%20renal%20failure.
  8. L.Devaraj. Nephrotic syndrome (Dridamula Basthi Shoth) Chapter 13 in Ayurveda Remedies for Kidney Diseases. Chaukhambha Publishers, Varanasi-221 001I (India) Ist Edition (2015):137-139
  9. Editor Mahesh M. Thakur. Yashaswi Chikitsa book in Hindi. Chapter 'Sarvang Shoth' (Nephrotic syndrome) by Vinay Velankar. Ayurved vyaspeeth prakashan, Nashik-422 001. First edition 2022:363-365
  10. Commentator Pt. Vishwanath Dwivedi. Bhavprakash Nighantu. Motilal Banarasidas, Delhi-7. Eighth edition.1974. Erand patra: Guduchyadi varg verse 60-61:161
  11. Commentator Pt. Vishwanath Dwivedi. Bhavprakash Nighantu. Motilal Banarasidas, Delhi-7. Eighth edition.1974. Pippali: Haritkyadi varg verse 53-58:14
  12. Editor Acharya Radhakrishna Parashar. Sharangdhar sanhita-Madhyam khand. Shri Baidyanath Ayurved Bhavan Pvt.Ltd., Nagpur. Nineth edition 2012. Chapter 2, verse 108: 207
  13. Vaidya Dnyaneshwar Patil. Chapter 1. Vrikkarog-Panchbhautic chikitsa Vichar-Gokshuradi Guggul in book Vrikka vikar Parisamvad. Vaidyaraj Datar Panchbhautic Chikitsa Va Sanshodhan Kendra, Sangli. First Edition. 2017: 17-18
  14. Laghumalini vasant. https://www.1mg.com/otc/baidyanath-noida-laghumalini-vasant-ras-otc714520?wpsrc=Google+Organic+Search
  15. Boerhaavia diffusa. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053255/
  16. Kulkarni Yogini Ramchandra: Search for Nephroprotectives; Thesis submitted to Pune university for PhD in Ayurveda:2003: 347-357
  17. Editor Rajeshwardatta Shastri. Bhaishajya Ratnavali. Chaukhambha Sanskrit Santhan, Varanasi-221 001. 16th Edition. 2002. Adhyay  42, verse 13:557.

Corresponding Author

Dr. Sarita Gaikwad

Director, Punarnava Trimarma Chikitsalay and Research Center, Ganesh nagar road, Nanded-431 602 (Maharashtra state, India)

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