Acute Kidney Injury and Homoeopathy

Dr Nidhi Dave 

Acute kidney injury (AKI) (formerly acute renal failure) is the syndrome arising from a rapid fall in GFR (over hours to days). Acute kidney injury (AKI) is defined by the impairment of kidney filtration and excretory function over days to weeks, resulting in the retention of nitrogenous and other waste products normally cleared by the kidneys. AKI is not a single disease but, rather, a designation for a heterogeneous group of conditions that share common diagnostic features. It is important to recognize that AKI is a clinical diagnosis and not a structural one. A patient may have AKI with or without injury to the kidney parenchyma. AKI can range in severity from asymptomatic and transient changes in laboratory parameters of glomerular filtration rate (GFR), to overwhelming and rapidly fatal derangements in effective circulating volume regulation and electrolyte and acid- base composition of the plasma. 

It is characterized by retention of both nitrogenous (including Ur and Cr) and non-nitrogenous waste products of metabolism, as well as disordered electrolyte, acid – base, and fluid homeostasis. 

There is evidence that even relatively small acute reductions in kidney function are associated with poorer outcomes, including increased mortality, higher risk of long-term dialysis, and longer hospital stay. 

Homoeopathic approach
Sometimes they may be acute exacerbation of chronic disease. In such conditions as per § 92

But if it is a disease of a rapid course, and if its serious character admit of no delay, the physician must content himself with observing the morbid condition, altered though it may be by medicines, if he cannot ascertain what symptoms were present before the employment of the medicines, – in order that he may at least form a just apprehension of the complete picture of the disease in its actual condition, that is to say, of the conjoint malady formed by the medicinal and original diseases, which from the use of inappropriate drugs is generally more serious and dangerous than was the original disease, and hence demands prompt and efficient aid; and by thus tracing out the complete picture of the disease he will be enabled to combat it with a suitable homoeopathic remedy, so that the patient shall not fall a sacrifice to the injurious drugs he was swallowed. 

Apis Melifica: – Acts on cellular tissues causing oedema of skin and mucous membranes. Swelling or puffing up of various parts, oedema, red rosy hue, stinging pains, soreness, intolerance of heat, and slightest touch, and afternoon aggravation are some of the general guiding symptoms. Thirst less; Burning and soreness when urinating. Suppressed, loaded with casts; frequent and involuntary; stinging pain and strangury; scanty, high coloured. Incontinence. Last drops burn and smart. Worse, heat in any form; touch; pressure; late in afternoon; after sleeping; in closed and heated rooms. Right side. Better, in open air, uncovering, and cold bathing. 

Apocynum: – Increases secretions of mucous and serous membranes and acts on cellular tissue, producing oedema and dropsy and on skin causing diaphoresis.; diminished frequency of pulse; Bladder much distended. Turbid, hot urine, with thick mucus and burning in urethra, after urinating. Little expulsive power. Dribbling. Strangury. Renal Dropsy. 

Acid Benz: – uric acid diathesis, with urine highly coloured and very offensive, and gouty symptoms. Renal insufficiency. Pains suddenly change their locality. Repulsive odour; changeable colour; brown, acid. Enuresis; dribbling, offensive urine of old men. Excess of uric acid. Cystitis. Worse,
motion, standing 

Acid Nitric: – Scanty, dark, offensive. Smells like horse’s urine. Cold on passing. Burning and stinging. Urine bloody and albuminous. Alternation of cloudy, phosphatic urine with profuse urinary secretion in old prostatic cases. Worse, evening and night, cold climate, and also hot weather. Better, while riding in carriage  

Berberis vulgaris: – Rapid change of symptoms-pains change in regard to place and character-thirst alternates with thirst lessness, hunger, and loss of appetite; arthritic affections with urinary disturbances. Wandering, radiating pains. Burning pains. Sensation as if some urine remained after urinating. Urine with thick mucus and bright-red, mealy sediment. Bubbling, sore sensation in kidneys. Pain in bladder region. Pain in the thighs and loins on urinating. Frequent urination; urethra burns when not urinating. Worse, motion, standing. It brings on, or increases, urinary complaints. 

Belladonna: – Belladonna stands for violence of attack and suddenness of onset. Useful in hypertensive emergencies. Vertigo, with falling to left side or backwards. Sensitive to least contact. Much throbbing and heat. fullness, especially in forehead, also occiput, and temples. Retention of urine. Acute urinary infections. Sensation of motion in bladder as of a worm. Urine scanty, with tenesmus; dark and turbid, loaded with phosphates. Worse, touch, jar, noise, draught, after noon, lying down. Better, semi-erect. 

Cantharis: – Over sensitiveness of all parts. Irritation. Raw, burning pains. Haemorrhages. Intolerable, constant urging to urinate; Intolerable urging and tenesmus. Nephritis with bloody urine. Violent paroxysms of cutting and burning in whole renal region, with painful urging to urinate; bloody urine, by drops. Intolerable tenesmus; cutting before, during, and after urine. Urine scalds him, and is passed drop by drop. Constant desire to urinate. Membranous scales looking like bran in water. Urine  jelly-like, shreddy. Worse, from touch, or approach, urinating, drinking cold water or coffee. Better, rubbing. 

HELLEBORUS NIGER: – general muscular weakness; useful in low states of vitality and serious disease. Suppressed; scanty, dark; coffee-grounds sediment. Frequent urging. Bladder overdistended. Worse, from evening until morning, from uncovering. 

Ipecac: – persistent nausea and vomiting, Moorages bright-red and profuse. Worse, periodically; from veal, moist warm wind, lying down.; Pre renal AKI 

Litres S: – Renal dropsy. Here the suppressed urination is most favourably influenced. General anasarca due to heart and kidney disease. Diarrhoea with violent urging and pain in lower part of back. Colic. Locally, applied to ulcers and unhealthy wounds. A prompt diuretic. 

Medorrhinum: – A powerful and deep-acting medicine, often indicated for chronic ailments due to suppressed gonorrhoea. Oedema of limbs; dropsy of serous sacs. Painful tenesmus when urinating. Renal colic; Urine flows very slowly. Worse, when thinking of ailment, from daylight to sunset, heat, inland. Better, at the seashore, lying on stomach, damp weather. 

Nat Mur: – symptoms of salt retention as evidenced by dropsies and oedemas; an alteration in the  blood causing a condition of anćmia and leucocytosis. There seems also to be a retention in the tissues  of effected materials giving rise to symptoms loosely; Dry mucous membranes; Great weakness and weariness. Pain just after urinating. Increased, involuntary when walking, coughing, etc. Has to wait a long time for it to pass if others are present.; Worse, noise, music, warm room, lying down about 10  am; at seashore, mental exertion, consolation, heat, talking. Better, open air, cold bathing, going  without regular meals, lying on right side; pressure against back, tight clothing. 

Nux Vomica: – Irritable bladder; from spasmodic sphincter. Frequent calls; little and often. Haematuria. Ineffectual urging, spasmodic and strangury. Renal colic extending to genitals, with dribbling urine. While urinating, itching in urethra and pain in neck of bladder. Post renal AKI; Worse, morning, mental exertion, after eating, touch, spices, stimulants, narcotics, dry weather, cold. Better, from a nap, if allowed to finish it; in evening, while at rest, in damp, wet weather, strong  pressure. 

Oxalic Acid: – Frequent and copious. Burning in urethra and pain in glans when urinating. Must urinate when thinking of it. Urine contains oxalates. Worse, left side; slightest touch; light;  shaving. All conditions made worse by thinking about self. 

SERUM-ANGUILLAE (Eel Serum):- presence of albumin and renal elements in the urine, the  haemoglobinuria, the prolonged anuria (24 and 26 hours), Whenever the kidney becomes acutely  affected, either from cold or infection or intoxication, and the attack is characterized by oliguria,  anuria and albuminuria, efficacious to re-establish diuresis, and in rapidly arresting albuminuria. hypertension and oliguria, without oedema. cardiac uraemia. acute nephritis a frigorie; Subacute  nephritis. Heart diseases, in cases of failure of compensation and impending asystole. 

Terebinth: – Inflammation of kidneys, with haemorrhages-dark, passive, fetid. Bright’s disease preceded by dropsy (Goullon). Drowsiness and strangury. Strangury, with bloody urine. Scanty, suppressed, odor of violets. Urethritis, with painful erections. Inflamed kidneys following any acute disease. Constant tenesmus. 

Thuja Occ:- Rapid exhaustion and emaciation. Left-sided and chilly medicine; Great Anti sycotic drug; Complains arise after suppressed gonorrhoea; Urethra swollen inflamed. Urinary stream split and small. Sensation of trickling after urinating. Severe cutting after. Frequent micturition accompanying pains. Desire sudden and urgent, but cannot be controlled. Paralysis sphincter vesicae. Worse, at night, from heat of bed; at 3 am and 3 pm; from cold, damp air; after breakfast; fat, coffee;  vaccination. Better, left side; while drawing up a limb. 

Urea Pura:- Renal dropsy, with symptoms of general intoxication; Albuminuria, diabetes; urćmia. Urine thin and of low specific gravity. A hydrogogue diuretic in the treatment of dropsies. 10 grains every 6 hours. 

Urtica urens:- Useful in cases when there is high serum uric acid levals; gouty & rheumatic diathesis; Worse, from snow-air; water, cool moist air, touch. 

Zinzibar off:- in orifice. Yellow discharge from urethra. Urine thick, turbid, of strong odor, suppressed. Complete suppression after typhoid. After urinating, continues to ooze in drops. 

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