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World Diabetes Day 2021: What Is Diabetic Nephropathy? How Does Holistic Ayurveda Care Help The Condition?

Diabetes nephropathy is a dreaded complication of diabetes usually observed after a decade or half a decade of diagnosis. It is estimated that one-third diabetic population may develop (CKD) chronic kidney disease. Usually patient gests the first indication of kidney function as oedema or urinary infection or elevated urine microalbumin. The kidney is an important body organ that helps to eliminate nitrogenous waste material and in mammals, the nitrogenous waste products are eliminated chiefly as urea (by urine).

The patient may develop signs of uremia at a very later stage when kidney function gets grossly deranged and chances for regression of disease remains rare only. In this stage, the patient may require dialysis (haemodialysis which may add to electrolyte dysfunction, blood loss, gross disharmony, etc.) and the last option remains is an organ transplant.

Technique for organ transplant has advanced a lot in the last few years but the availability of human organs is not an easy task. Moreover, the recipient of a transplant may require life long immune depressant.

Chronic kidney dysfunction is a progressive disease and occurs due to irreversible damage to the kidney. If the morbid condition is identified at its early stage the management becomes easy and at least the speed of progression can be reduced to improve the span of life. Holistic care seems the best option that can help in arresting and delaying of progressive kidney dysfunction. The combined approach of analysis through modern means like urine microalbumin evaluation & renal angiography with herbal - Ayurveda medication can help in reducing the need for haemodialysis or delaying it. Thus it would help in reducing the burden of the health care system so that they can use their resources on severely ill patients.

Identification Of Problem

Chronic kidney disease is characterised by leaking protein into the kidney i.e. proteinuria or chiefly albumin in the urine. The presence of albumin in the urine is due to the dysfunction of the glomerulus (filtration apparatus of the kidney). These are changes in blood capillaries and this morbid condition is referred to as angiopathic changes.

Angiopathy is a chronic change observed in vascular tissues over a period of time when the vascular tissues grossly change due to mitochondrial dysfunction (mitochondria is the powerhouse of body tissue). Glucose is the body fuel and mitochondria metabolize the glucose to produce necessary energy. When the body tissues don't receive the necessary glucose the tissues start using lipids (fats) for energy needs. When this continues for a long time it leads to permanent changes that eventually lead to tissue dysfunction.

This leads to the leaking of microalbumin from the glomerulus this is the first sign of kidney dysfunction. In the initial stages, the patient may complain of indigestion, puffiness around the eyes & face, oedema - swelling on legs, vomiting or nausea, progressive weakness, and anaemia. The disease is progressive in nature and holistic Ayurvedic medical management may help in prolonging the ongoing damage and delay in further kidney damage. This simple measure can reduce the burden on the medical system and their resources may be better used in critically ill patients.

When To Seek Medical Consultation?

Regular and periodical medical check-ups and consultations are advisable for diabetic patients. If a diabetic patient develops anaemia, swelling or puffiness the patient ought to consultant for the medical problem as it could be an early sign of kidney dysfunction.

Holistic Ayurvedic Health Care

The ancient texts like Charaka Samhita and Sushruta Samhita wrote about diabetic complications. The complication in diabetes may also be due to improper medical management, improper diet plan along poor glycaemic control. The ancient text narrates that the complications like an abdominal lump, or paresis, phthisis, urinary dysfunctions, pain in the lower abdomen, incontinence of urine, are due to poor nutritional status of the tissues. This phenomenon is narrated as Apatarpana i.e. the medical management, diet & regimens that reduce body mass or may be understood as a mild form of starvation. This tissue starvation may be due to improper uptake of glucose by the tissues also may be due to blockage of the receptors on tissues that facilitate the transport of glucose from blood/plasma to body tissues. This change is narrated as the increase of material on one side and scarcity on the other.

This can be corrected with the drugs having Rasayana properties. Rasayana drugs may be used for health prevention, health promotion and curing morbid conditions. These drugs act by correcting nutritional principles and felicitating normal nutritional supply to the entire body. Thus they help to prevent disease, offer the quality of life and improve wellbeing. The classic writes that the proper and timely use of Rasayana drugs has the following beneficial effects - increases longevity, improves memory, improve cognition, improves host diffence & homeostasis, youth, improves complexion & glow, good voice quality, improves functions of sensory & motor apparatus and improves strength & vigour. The classical quote for benefits of the use of Rasayana is narrated here:

"दीर्घमायुः स्मृतिं मेधामारोग्यं तरुणं वयः|प्रभावर्णस्वरौदार्यं देहेन्द्रियबलं परम्||७|| वाक्सिद्धिं प्रणतिं कान्तिं लभते ना रसायनात्| लाभोपायो हि शस्तानां रसादीनां रसायनम्||८||"

Health Care Options For Diabetes In Ayurveda

The health care option available in Ayurveda in diabetes and prevention of its complications includes therapeutic purification (known as Panchakarma), therapeutic medicinal management by herbal medicaments, polyherbal compounds, herbomineral compounds (to be used under strict observations) and mineral preparations (need more care to seek regular medical advice and follow regulations), lifestyle managements - diet, regimen design. These ought to be included with psychological healing practices like Yoga, meditation, following Achara Rasayana, etc.

The important herbal options to improve kidney health in diabetes patients include Amla (Indian gooseberry), Giloya, Punarnava, Gokshru, Shatavari (asparagus), Bhallatak (marking nut), etc. Shiajeet is also considered a kidney preventive drug (if pure Shilajeet is taken - a cheaper of Shilajeet or its counterfeit tar may prove to be nephrotoxic so authentic Shilajeet will help and will help in reducing problem but if impure Shilajeet or counterfeit is used it is surely going to harm kidney)
Periodical purification recommended in seasonal regimens helps in improving health by reducing the corrosive effects of seasonal variations. Basti is also a procedure that can be performed for a better quality of life.

These health care options can be employed on the basis of individual's constitution, stage of disease, Vikruti i.e. extent of disharmony in biological triode (Dosha, Dhatu & Mala) age, the strength of individual, season and effects on human, individual's digestive strength, etc. the procedure or medicament used for one may not be needed for other. As each and every individual is unique and the problem may have occurred differently so Ayurveda emphasis treating and crafting treatment and set goals for management and plan the treatment accordingly.