An Approach towards in Management of Chronic Kidney Disease
Keywords:
Chronic kidney disease, proteinuria, hypertension, progression, Ayurvedic drugsAbstract
The current international guidelines defines and classify the chronic kidney disease (CKD) as decreased kidney function shown by decreased glomerular filtration rate(GFR). Glomerular filtration rate 60ml\min\1.73m2 for at least 3 months as a marker for kidney damage. The underlying causes for chronic kidney disease are proteinuria, and hypertension. It is the main cause of CKD in many high, middle and low income countries. In different countries the incidences, and progression of the CKD varies by ethnicity and social determinants of health, possibly through epigenetic influences. Many people having the symptoms of itching, loss of appetite and lethargy. When symptoms becomes severe diagnosis is done by small screening(urinary dipstick or blood test). The best indicator of kidney function is GFR. There is many complication occurs during the CKD such as anemia due to decreased production of erythtropoietin by renal, and mineral bone disease due to disturbances in the metabolism of Vitamin D, Calcium and Phosphate, reduced red blood cell survival and iron deficiency. CKD patients are five or ten times more likely to die prematurely because their is a progress in end renal stage disease. Interventions are to targeting the specific symptoms and aimed at educational supporting or change in standard of living , make a positive difference with CKD patients lifestyle. Their is some treatment in ayurvedic system for CKD.References
Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. Lancet. 2017; 389(10075): 1238–1252p. doi:10.1016/S0140-6736(16)32064-5
Wühl E, Schaefer F. Therapeutic Strategies to Slow Chronic Kidney Disease Progression. Pediatr Nephrol. 2008; 23(5): 705–716p. doi:10.1007/s00467-008-0789-y
Van Rensburg B, Meyer AM. Clinical Aspects of Chronic Kidney Disease. South African Med J. 2015; 105(3): 237p. doi:10.7196/SAMJ.9413.
Bakris GL, Williams M, Dworkin L, et al. Preserving Renal Function in Adults with Hypertension and Diabetes: A Consensus Approach. Am J Kidney Dis. 2000; 36(3): 646–661p. doi:10.1053/ajkd.2000.16225
JCP, SA, JMB, et al. Blood Pressure Control, Proteinuria, and the Progression of Renal Disease: The Modification of Diet in Renal Disease Study. Ann Intern Med. 1995; 123(10): 754–762p.
Abecassis M, Bartlett ST, Collins AJ, et al. Kidney Transplantation as Primary Therapy for End-Stage Renal Disease: A National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (NKF/KDOQITM) Conference. Clin J Am Soc Nephrol. 2008; 3(2): 471–480p. doi:10.2215/CJN.05021107
Jacob P, Hartung R, Bohlender J, Stein G. Utility of 24-h Ambulatory Blood Pressure Measurement in a Routine Clinical Setting of Patients with Chronic Renal Disease. J Hum Hypertens. 2004; 18(10): 745–751p. doi:10.1038/sj.jhh.1001734
Risdon RA, Sloper JC, De Wardener HE. Relationship between Renal Function and Histological Changes Found in Renal-Biopsy Specimens from Patients with Persistent Glomerular Nephritis. Lancet. 1968; 2(7564): 363–366p. doi:10.1016/s0140-6736(68)90589-8
Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ. Plasma Lipids and Risk of Developing Renal Dysfunction: The Atherosclerosis Risk in Communities Study. Kidney Int. 2000; 58(1): 293–301p. doi:10.1046/j.1523-1755.2000.00165.x
Abrass CK. Cellular Lipid Metabolism and the Role of Lipids in Progressive Renal Disease. Am J Nephrol. 2004; 24(1): 46–53p. doi:10.1159/000075925
Kang DH, Kanellis J, Hugo C, et al. Role of the Microvascular Endothelium in Progressive Renal Disease. J Am Soc Nephrol. 2002; 13(3): 806–816p.
Orphanides C, Fine LG, Norman JT. Hypoxia Stimulates Proximal Tubular Cell Matrix Production via a TGF-β1-Independent Mechanism. Kidney Int. 1997; 52(3): 637–647p. doi:10.1038/ki.1997.377
Karamouzis I, Sarafidis PA, Karamouzis M, et al. Increase in Oxidative Stress but not in Antioxidant Capacity with Advancing Stages of Chronic Kidney Disease. Am J Nephrol. 2008; 28(3): 397–404p. doi:10.1159/000112413
Brunelli SM, Lewis JD, Gupta M, Latif SM, Weiner MG, Feldman HI. Risk of Kidney Injury Following Oral Phosphosoda Bowel Preparations. J Am Soc Nephrol. 2007; 18(12): 3199–3205p. doi:10.1681/ASN.2007040440
Baudoin P, Provoost AP. Effects of age at the time of unilateral nephrectomy and dietary protein on long-term renal function in rats. Pediatric Nephrology. 1993; 7(5): 536–542p.
Schrier RW, Estacio RO, Esler A, Mehler P. Effects of Aggressive Blood Pressure Control in Normotensive Type 2 Diabetic Patients on Albuminuria, Retinopathy and Strokes. Kidney Int. 2002; 61(3): 1086–1097p. doi:10.1046/j.1523-1755.2002.00213.x
Altemose KE, Brady TM. Pediatric Hypertension. Curr Treat Options Pediatr. 2019; 5(2): 61–77p. doi:10.1007/s40746-019-00151-w
Jafar TH, Schmid CH, Landa M, et al. Angiotensin-Converting Enzyme Inhibitors and Progression of Nondiabetic Renal Disease. A Meta-Analysis of Patient-Level Data. Ann Intern Med. 2001; 135(2): 73–87p. doi:10.7326/0003-4819-135-2-200107170-00007
Izuhara Y, Nangaku M, Inagi R, et al. Renoprotective Properties of Angiotensin Receptor Blockers beyond Blood Pressure Lowering. J Am Soc Nephrol. 2005; 16(12): 3631–3641p. doi:10.1681/ASN.2005050522
Wilmer WA, Rovin BH, Hebert CJ, Rao SV, Kumor K, Hebert LA. Management of Glomerular Proteinuria: A Commentary. J Am Soc Nephrol. 2003; 14(12): 3217–3232p. doi:10.1097/01.ASN.0000100145.27188.33
Kumagai H, Hayashi K, Kumamaru H, et al. Amlodipine is Comparable to Angiotensin-Converting Enzyme Inhibitor for Long-Term Renoprotection in Hypertensive Patients with Renal Dysfunction: A One-Year, Prospective, Randomized Study. Am J Hypertens. 2000; 13(09): 980–985p.
Smidt UM, Andersen AR, et al. Early Aggressive Antihypertensive Treatment Reduces Rate of Decline in Kidney Function in Diabetic Nephropathy. Lancet. 1983;1(8335);1175-1179p.
Wright JT, Bakris G, Greene T, et al. Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease: Results from the AASK Trial. J Am Med Assoc. 2002; 288(19): 2421–2431p. doi:10.1001/jama.288.19.2421
Bakris GL, Fonseca V, Katholi RE, et al. Differential Effects of β-Blockers on Albuminuria in Patients with Type 2 Diabetes. Hypertension. 2005; 46(6): 1309–1315p. doi:10.116110.1161/01.HYP.0000190585.54734.48
Wühl E, Hadtstein C, Mehls O, Schaefer F. Home, Clinic, and Ambulatory Blood Pressure Monitoring in Children with Chronic Renal Failure. Pediatr Res. 2004; 55(3): 492–497p. doi: 10.1203/01.PDR.0000106863.90996.76
Newman R. For Personal Use. Only Reproduce with Permission from The Lancet Publishing Group. 2003; 361: 2003.
Fouque D, Laville M. Low Protein Diets for Chronic Kidney Disease in Non Diabetic Adults. Cochrane Database Syst Rev. 2009; (3): CD001892p. doi:10.1002/14651858.CD001892.pub3
Levey AS, Greene T, Sarnak MJ, et al. Effect of Dietary Protein Restriction on the Progression of Kidney Disease: Long-Term Follow-Up of the Modification of Diet in Renal Disease (MDRD) Study. Am J Kidney Dis. 2006; 48(6): 879–888p. doi:10.1053/j.ajkd.2006.08.023
Holdaas H, Wanner C, Abletshauser C, Gimpelewicz C, Isaacsohn J. The Effect of Fluvastatin on Cardiac Outcomes in Patients with Moderate to Severe Renal Insufficiency: A Pooled Analysis of Double-Blind, Randomized Trials. Int J Cardiol. 2007; 117(1): 64–74p. doi:10.1016/j.ijcard. 2006.06.003
Epstein M, Campese VM. Pleiotropic Effects of 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitors on Renal Function. Am J Kidney Dis. 2005; 45(1): 2–14p. doi:10.1053/j.ajkd.2004.08.040
Wühl E, Trivelli A, Picca S, et al. Strict Blood-Pressure Control and Progression of Renal Failure in Children. N Engl J Med. 2009; 361(17): 1639–1650p. doi:10.1056/NEJMoa0902066
Zoja C, Corna D, Rottoli D, et al. Effect of Combining ACE Inhibitor and Statin in Severe Experimental Nephropathy. Kidney Int. 2002; 61(5): 1635–1645p. doi:10.1046/j.1523-1755.2002.00332.x
Matteucci MC, Wühl E, Picca S, et al. Left Ventricular Geometry in Children with Mild to Moderate Chronic Renal Insufficiency. J Am Soc Nephrol. 2006; 17(1): 218–226p. doi:10.1681/ ASN.2005030276
Rettig RA, Norris K, Nissenson AR. Chronic Kidney Disease in the United States: A Public Policy Imperative. Clin J Am Soc Nephrol. 2008; 3(6): 1902–1910p. doi:10.2215/CJN.02330508
Dwivedi D, Pandey AK, et al. Management of Chronic Kidney Disease through Ayurveda: A Case Study. World J Pharm Pharm Sci. 2017; 6(2): 1318–1325p.
Lam KSL, Cheng IKP, Janus ED, Pang RWC. Cholesterol-Lowering Therapy may Retard the Progression of Diabetic Nephropathy. Diabetologia. 1995; 38(5): 604–609p. doi:10.1007/ BF00400731
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