glomerular disease presentation homoeopathy medicine

Homoeopathy and glomerular disease

1.                      STATE GHAZIPUR HOMOEOPATHIC MEDICAL COLLEGE, GHAZIPUR UP                 DEPARTMENT OF PRACTICE OF MEDICINE                                                 Seminar   on       TOPIC:- GLOMERULAR DISEASES                  1. ACUTE NEPHRITIC SYNDROME                  2. NEPHROTIC SYNDROME                                     Under the guidance of:- Dr. Sunrita Das ma'am {Asst. Professor} Dr. Dharmesh Gujarati Sir  {Asst. Professor}         P resented b y :-     Anant Shukla  (2008587541004)    Final Year

2.       RENAL     SYSTEM

3.       Kidney:- Introduction Bean shaped paired organs  Weighing about 150 gm in adult male and about 135 gm in female Hilum of kidney is situated at the midpoint medial aspect where the artery, vein, lymphatic and ureter are located. Surrounded by a thin fibrous capsule  ANATOMICAL POSITION :- T12-L3 LENGTH :- 10-14 CM (MALES) 9-13CM (FEMALES) BREADTH:-   3-5 CM  THICKNESS:- 2-3 CM 

4.          KIDNEY:- cross section 

6.                             GLOMERULUS   Glomerulus is tuft of capillaries enclosed by   Bowman's capsule.  It consist of afferent arterioles and efferent arterioles  Diameter of efferent arterioles is less than that of afferent arterioles. It is the filtering unit of the kidney, is a unique bundle of capillaries lined by delicate fenestrated endothelia. 

7. GFR (GLOMERULUS FILTRATION RATE)  Glomerular filtration rate (GFR) is the volume of fluid filtered from the  renal  (kidney)  glomerular  capillaries into the  Bowman's capsule  per unit time.  The normal range of GFR, adjusted for  body surface area , is 100–130 average 125 mL/min  in men and 90–120 mL/min in women younger than the age of 40.

8.                   GLOMERULAR DISEASES    DEFINITION:-   Glomerular diseases are the result of conditions that affect a specific part of your kidney called glomeruli.   They encompass large and clinically significant group of renal disease   Glomerulonephritis or Bright's disease is the term used for disease that primarily involve the renal glomeruli    CLASSIFICATION:- Glomerular disease can be divided into 2 broad groups :- ---> Primary glomerulonephritis :- Glomeruli are the predominant site                               of  involvement ---> Secondary glomerular disease :- Include certain systemic disease and                          hereditary disease which secondarily affect the glomeruli 

9. Antibody mediated cell injury

10.   ACUTE NEPHRITIC SYNDROME   Glomerulonephritis is characterized by inflammation and thinning of the  glomerular basement membrane  and the occurrence of small pores in the  podocytes  of the  glomerulus PATHOGENESIS :-  ANTI-GBM ASSOCIATED  SYMPTOMS   --> HAEMATURIA :- Erythrocytes are detectable by microscope   --> PROTEINURIA :- Less than 3gm/24 Hrs --> HYPERTENSION :- Depend upon the severity of disease --> OLIGURIA :- Less than 400 ml --> OEDEMA :- Mild and results from sodium and water retention   --> Breathlessness due to pulmonary oedema  --> General symptoms like malaise, anorexia, vomiting, headache 

11. --> MICROSCOPIC :- RBCs , leucocyte, epithelial and granular casts  --> CBC :- Leucocytosis with increased polymorphs. ESR is high  --> Blood urea :- Increased  --> ASO tires   --> Anti GBM antibody levels  --> USG   --> Renal biopsy DIFFERENTIAL DIAGNOSIS   --> Acute pyelonephritis  --> Embolic nephritis  INVESTIGATIONS 

12. COMPLICATIONS --> Hypertensive encephalopathy  --> Acute renal failure  (Rarely) --> Severe anasarca  --> Secondary infection :- Bronchitis, peritonitis   TREATMENT   --> Bed rest till hematuria, hypertension and edema have disappear --> Diet:- intake of protein should be reduced  --> FLUIDS:- Restricted to half a liter per day  --> Salt should not be added to food 

13.         Nephrotic syndrome   --> Nephrotic syndrome is a constellation of features in different  diseases having varying pathogenesis ; characterized by findings of massive proteinuria, albuminuria, oedema, hyperlipidemia, lipiduria , and hypercoagulability. --> ETIOLOGY    Diabetic nephropathy – called KW syndrome  Membranous nephropathy  Focal and segmental glomerulosclerosis  Crescentric glomerulonephritis

14. SYMPTOMS  Swelling over face (first periorbital area). Face become almost round commonly known as moon shaped face  Insomnia, restlessness, anorexia, headache etc. Vague GI disturbances Breathlessness due to hydrothorax Oedema in general   Heavy proteinuria  INVESTIGATIONS Urine examination :- albumin present in large quantity  Serum cholesterol :- always high 600-700 mg  BMR :- Low  Special investigations :- serum complement levels, ASO titre , Anti GBM antibodies etc. 

15. COMPLICATIONS Uremia  Hematuria TREATMENT Reduce fluid overload Reduce Salt intake  Measures to reduce hypertension Corticosteroids (prednisone) are used to induce remission in nephrotic syndrome  Diuretics are used to reduce edema ACE inhibitors and angiotensin II receptor blockers can reduce proteinuria 

16. Contrasting feature of acute nephritic and nephrotic syndrome   NEPHRITIC SYNDROME POTEINURIA :- Mild ( <3gm per 24 hrs ) HYPOALBUMINAEMIA :- Absent MECHANISM OF OEDEMA :- Na+ and Water Retention HAEMATURIA :- Present HYPERLIPIDAEMIA :- Absent LIPIDURIA :- Absent HYPERCOAGULABILTY :- Absent HYPERTENSION :- Present  NEPHROTIC SYNDROME Heavy (>3gm per 24 hrs ) 2. Present 3. Decreased plasma osmotic pressure, Na+ and water retention 4. Absent  5. Present  6. Present 7. Present 8. Present in advance disease

17. HOMOEOPATHIC MEDICINES FOR GLOMERULAR DISEASES APIS MELIFICA :- Patient exhibits swelling of face and extremities. Can used to be treat any form of Bright's disease which is accompanied by dull pain in kidneys ARSENIC ALBUM :- Patient have darkened urine which contains albumin and urge to urinate may be more frequent. BELLADONA :- Use to treat inflammation of the kidneys that is accompanied by burning pains in the lumbar region  CANTHARIS :- Kidney failure that causes cutting pain in lumbar region. Scanty urine that may have blood . CONVALLARIA :- Kidney failure caused by heart conditions can be treated . In such cases, along with the symptoms of kidney failure, that may also complain of an irregular heartbeat

18.       ORGANON APPROACH TOWARDS GLOMERULAR DISEASES §18:- Besides the totality of symptoms nothing can by any means be discovered in disease wherewith they could express their need of aid, it follows undeniably that the sum of all the symptoms in each individual case of disease must be sole indication, the sole guide to direct us in the remedy. §7:- the totality of these symptoms of t his outwardly reflected picture of internal essence of the disease, that is the affection of the vital force   §5:- as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to chronic miasm  

19. §78:- The true natural chronic diseases are those that arise from a chronic miasm  , which when left to themselves, and unchecked by the employment of those remedies that are specific for them , always go on increasing  and growing worse  §80:- the monstrous internal chronic miasm – the psora , the psora is the only real fundamental cause and producer of all the other numerous                                     HOMOEOPATHIC INVENTION  As per the latest research, it may be caused by an abandonment or existence conflict. Abandonment conflicts are brought on by feeling ousted, excluded, unwanted, rejected, not understood, ignored, left out, isolated, and alone. 

20. Repertorial approach towards glomerular disease   SYNTHESIS REOERTORY :-  URINE – Bloody – Bell. , Ham. ,Arg-nit. Etc.                                                KIDNEY – Renal failure - Apis, Lach. , etc.                                              KIDNEY – Polycystic kidneys – kres . Napthoq . etc PHATAK'S REPERTORY :- KIDNEY – Inflammation  BTPB :- URINARY ORGANS – Kidney- APIS, BERBERIS, Cannabis i . , thlaspi . BBCR:- URINARY ORGANS – Kidneys in general:- Bell. CANTH. LYC. Zinc  KENT REPERTORY :-  URINE – ALBUMIOUS – Lyc. Ph-ac.                                      KIDNEYS – INFLAMMATION :- Apis, Bell, Canth . 

21. HOMOEOPATHIC JOURNAL