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Dr. Santosh Yadav (M.D.)
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Nephrotic Syndrome
Nephrotic Syndrome is a kidney disorder which is characterized by
1. Abnormal protein leak
2. Low levels of proteins in blood (due to protein leakage)
3. Increased levels of lipid
4. Swelling of body parts (called edema).

The term Nephrotic Syndrome is coined from two words: Nephros (in Greek) meaning kidney and Syndrome denoting a group of symptoms.

Nephrotic Syndrome is a set of symptoms related to kidney dysfunction, and not a disease, in and of itself.

Nephrotic Syndrome is a disorder characterized by loss of proteins in the urine. In realism, Nephrotic Syndrome can be the first sign of various diseases that damage the kidneys, especially tiny blood-filtering units (glomeruli) in the kidneys, where urine is formed. This causes fall in the protein levels in the blood, and water to move into body tissues, causing swelling and bloating of body (edema/Oedema).
To know what is Nephrotic Syndrome, let us first briefly understand the structure and function of the kidneys.

The kidneys are two bean-shaped organs found in the lower back. They are about the size of a fist. The kidneys are like body’s filters, which remove impurities or wastes from the blood via the urine and return the cleaned blood back to the body. Each of these kidneys has millions of units to filter blood called glomeruli. Glomeruli are tiny blood vessels that form a meshwork in the kidney through which blood is strained to filter out excess water and waste products.

When the kidneys are working well, they clean the blood and get rid of waste products, excess salt, and water. When diseased, the kidneys may get rid of things that the body needs to keep, such as proteins and blood cells.

The normal architecture of the glomeruli prevents a majority of protein from getting filtered into the urine and this holds protein in the blood. Protein help the blood soak up water from tissues. But kidneys with damaged filters may let protein leak into the urine. As a result, not enough protein is left in the blood to soak up the water. The water then moves from the blood into body tissues, producing swelling. This swelling may be most noticeable around the eyes, legs, hands, belly, etc.

Normally, a person loses less than 150 mg of protein in the urine in a 24-hour period. However, patient of Nephrotic Syndrome will loose more than 3.5 grams or more of protein during a 24-hour period, or 25 times the normal amount. As body looses this vital protein in the urine, this results in drop of protein in the blood called hypoproteinemia or hypoalbuminemia, another cardinal feature of Nephrotic Syndrome.

Hypercholesterolemia (high blood cholesterol) is common in Nephrotic Syndrome. In addition to albumin, other important enzymes involved in cholesterol metabolism, slip through the glomeruli, which contribute to high blood cholesterol.

Homeopathic treatment for Nephrotic Syndrome:
Homeopathy has a well-defined and promising role to play in for the treatment of Nephrotic Syndrome. Experience based and evidence proven results indicate that the homeopathic treatment can offer following results:
a. It can reduce the frequency of attacks of Nephrotic Syndrome
b. It can reduce the duration of each episode of Nephrotic Syndrome
c. It can reduce the attacks of frequent colds and infections, which in turn helps a great deal towards better control
d. It can help in reducing the dependency on cortisone and cyclosporine.
Irrespective of what causes Nephrotic Syndrome, the following are the most common signs and symptoms of the condition. However, it should be noted that each individual might experience symptoms differently.

Symptoms of Nephrotic Syndrome may include edema (swelling of face, abdomen and body), proteinuria (passing of protein in urine), hypoalbuminemia (low level of proteins in blood), and hyperlipidemia (high amount of lipids in blood).

1. Edema: Nephrotic Syndrome is characterized by proteinuria, hypoalbuminemia, and hyperlipidemia. The first noticeable outcome of all these metabolic deviations is edema or bloating of the body. It is the major clinical manifestation and presenting symptom in approximately 95-99% of cases with Nephrotic Syndrome. Edema often is so subtle in onset that the family may believe that the individual merely is gaining weight rapidly. Edema in the early phase appears in areas around the eyes, feet and hands, face.

In later stages, swelling may occur in the abdomen (ascites).
Ultimately, the edema may become generalized and can be massive (anasarca). Typically, edema often is worse on the face in the morning (upon arising) and is found predominantly in the lower extremities later in the day. It can cause feelings of tightness in the extremities, having an impact on one’s mobility.

2. Oliguria: Oliguria means reduction in the quantity of normal urine. The individual with Nephrotic Syndrome visits lavatory less often than before.

3. Hematuria: Hematuria means passage of blood in the urine. An occasional patient of Nephrotic Syndrome presents with gross hematuria.

4. General symptoms: Regardless of the type of Nephrotic Syndrome, patients commonly have loss of appetite (anorexia), become irritable, feel fatigued, and appear pale.

5. Diarrhea: Patients commonly complain of diarrhea, which is secondary to edema of the bowel wall.

6. Respiratory distress: If ascites is marked, patients commonly complain of respiratory distress, with difficulty in breathing or shallow, rapid breathing.

7. High blood pressure: Patients of Nephrotic Syndrome, whether young or old, have raised blood pressure.

8. Susceptibility to infections: Children with Nephrotic Syndrome occasionally present with fever and a septic picture. In a large fraction of these patients, the peritoneal cavity is the site of the infection.

9. Thromboembolism : Sometimes, patient with Nephrotic Syndrome get blood clots in the blood vessels of their legs or hands.
Nephrotic Syndrome is the outcome of number of diseases that damage the filtering units of the kidneys in a specific way that allows them to leak protein into the urine. Hence there is an array of diseases, which eventually end up in Nephrotic Syndrome. Some of the diseases that cause Nephrotic Syndrome, such as nephritis, affect only the kidney. Other diseases that cause Nephrotic Syndrome, such as diabetes and lupus erythematosus, affect other parts of the body as well. It should be also noted that in vast majority of cases exact cause cannot be pinpointed. The most common causes could be listed as under:

1. Local diseases (primarily affecting kidneys)
2. Systemic diseases (affecting various systems of body, one of them being kidney)
3. Allergy
4. Secondary to infections
5. Ill effects of drugs (e.g. antibiotics like penicillin or drugs given to control blood pressure)
6. Malignancy
7. Psychological factors
8. Idiopathic (Unknown causes)

1. Local causes:
This group categorizes all those conditions, which directly and primarily affect kidneys and damage glomeruli. Such conditions are largely termed as nephropathies or glomerulopathies. Some of them may be present since birth (e.g. congenital nephrosis) and others may be acquired during lifetime. Glomerulonephritis (GN) occupies peak position among glomerulopathies causing Nephrotic Syndrome. In GN, the kidneys' filters become inflamed and scarred and slowly lose their ability to remove wastes and excess water from the blood to make urine.

The basis of various nephropathies causing Nephrotic Syndrome is related to problem in the body's immune system. Under normal circumstances, immune system protects the body against invasion by foreign materials such as viruses and bacteria. However, if the immune system is not working properly, the kidneys may be harmed. The immune system may mistakenly attack the kidneys' filters (glomeruli) and cause them to become inflamed. To know more about this click here.

There are many various variants of GN, basically depending upon how the kidneys look under microscope in particular condition. To know more about them click here.

2. General/ systemic diseases:
This group categorizes all those diseases which affect wide spectrum of organs and systems in the body, one amongst them being kidney. When they affect kidney, they damage glomeruli and make them leak proteins. To enumerate some of them: Diabetes mellitus, systemic lupus erythematosus, Henoch-Schonlein purpura, multiple myeloma. To know more about them click here.

3. Allergy:
There is proven evidence that Nephrotic Syndrome is more common in individuals with family history or prior history of allergy. In fact, in number of cases Nephrotic Syndrome is precipitated by a hypersensitive event (e.g. insect sting, ant bites, poison ivy, and immunizations).

A few children have been reported with major food allergies along with Nephrotic Syndrome, and, in them, ultimate remission was associated with dietary elimination programs.

4. Infection:
In some cases Nephrotic Syndrome is thought to be result of or after effect of infectious conditions like malaria, infective endocarditis, hepatitis B and C, syphilis, streptococcal throat infection, etc.

5. Drug toxicity:
Certain modern medicines such as antibiotics (penicillin), antihypertensive medicines, gold preparations, etc are known to induce Nephrotic Syndrome in sensitive individuals.

6. Malignancy/ cancer:
Cancers of kidneys or lymphatic system (Hodgkin’s lymphoma) have potential of inducing Nephrotic Syndrome.

7. Psychological factor:
The mind plays a vital role in maintaining the health in general and in developing a wide range of disorders. There is proven evidence that emotional stress can produce alteration in our immune system. Some of the known causes of Nephrotic Syndrome like diabetes mellitus and SLE are offshoots of psychosocial stress.

8.Idiopathic :
List is not complete without this entity, which means no cause can be identified. In vast majority cases of Nephrotic Syndrome exact cause cannot be pinpointed.

During homeopathic management of Nephrotic Syndrome, a lot of stress is given towards causative factors and there are various medicines to encompass these factors. It will not be an over-exaggeration to state that homoeopathy was first to identify role of genetically determined tendencies as root cause of chronic diseases, which has now been confirmed by so-called modern medicine. Homeopaths take special effort to eliminate these predisposed tendencies and this goes in a long way in treating these chronic conditions rather than just suppressing their expressions.
Nephrotic Syndrome starts when disease-fighting proteins called antibodies become deposited along the wall of the delicate blood vessels that comprise the glomeruli. Antibodies are made by the immune system to fight microorganisms such as bacteria and viruses or other agents that can cause disease. Collectively all these agents, which make body form antibodies against them, are called as antigen. The exquisite sensitivity of the immune system to these foreign molecules provides an effective defense against invasion of the body by foreign material.

In some cases, however, the immune system is activated inappropriately in response to antigens that may not have potential to cause disease. These immune hypersensitivities are called allergies. When antibodies encounter and bind to antigens in the circulation, they may form very large complexes that have difficulty staying dissolved in the blood.
These complexes may fall out of solution in the glomeruli and become lodged in the small pores where the blood is filtered. When antigen-antibody complexes are deposited in the glomeruli, the body responds by mounting an inflammatory response to try to remove them. Ultimately, the inflammation can cause even more damage and impair the function of the glomeruli, leading to Nephrotic Syndrome.
Homeopathic Treatment:
Nephrotic Syndrome is a complex immunological disease affecting kidneys. Experience suggests that the conventional treatment alone is not enough to manage this disease. It has been proven that additional homeopathic treatment helps significantly towards better management of Nephrotic Syndrome.

How does it work? What to expect after homeopathic treatment?

- Homeopathic treatment aims at reducing
a. Frequency of attacks b. Severity and duration of attacks c. Cortisone dependency
-It aims at regulating autoimmune processes
- It works by controlling the protein leakage, by correcting the glomerular function of the kidney
- It aims are correcting the genetic tendencies
- It enhances immunity whereby the frequent infections such as colds, throat infections, etc. reduce drastically and hence the attacks of Nephrotic Syndrome.
- Homeopathy uses natural medicinal substances in ultra-minute quantity rendering a treatment that is extremely effective yet absolutely free from any side-effects whatsoever.

How much time does it take?
Nephrotic Syndrome is an obstinate, chronic and recurring disease. There is no shortcut to its cure.
The length of treatment varies form case to case, depending of the following factors:
Duration of Nephrotic Syndrome
Frequency of episodes of Nephrotic Syndrome
Extent of renal damage
Underlying cause
Over all immunological status of the patient
Current and previous medication such as cortisone and cyclophosphamide
General health and associated diseases

How is this achieved?
Homeopathy is supposed to work at the underlying multifactorial cause(s), i.e. the immunologically mediated parameters responsible for Nephrotic Syndrome; thereby treating the disease in such a way that the above targets are achieved. The homeopathic medicines are selected based on the certain guidelines; hence when administered, they are supported to provoke desirable immunological response, healing the tissue damage process in kidneys.

The methodology applied in treating the cases of Nephrotic Syndrome is clinically well proven. Some of the commonly used medicines may be described as under:
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