Treatment for Chronic kidney disease with Hypertension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Chronic kidney disease (CKD) is increasingly prevalent in most of the developed and developing countries in this world and hypertension is the most common comorbidity in chronic kidney disease. Treatment of hypertension in CKD patients can be challenging, as these patients often have severe hypertension requiring the use of multiple medications to achieve target blood pressure. The target blood pressure for CKD patients is generally lower than others. As ideal BP for normal healthy humans is 130/80mmHg while for CKD patients is less than 125/75mmHg. 

Management of Hypertension in Chronic Kidney Disease

Also Read : Effects of Ayurvedic treatment on patients of chronic renal failure

There are two management philosophies that support the significance of hypertension in CKD. The first is that having high blood pressure significantly raises the chance of developing heart disease, a stroke, peripheral artery disease, and progressive renal failure. When proteinuria is present, this risk is increased.

The second thought states that hypertension is the second most common cause of end-stage renal disease behind diabetes. It is evident that the majority of patients with diabetes and CKD also suffer hypertension. 

We aim to lower the BP in patients suffering from CKD to preserve the target organ function. It has also seen that patients die from heart disease rather than reach end-stage renal disease. Therefore, it is critical to adequately manage the blood pressure in CKD patients so as to reduce the likelihood of developing cardiovascular disease.

Treatment

The modern approach to treat this condition uses the combination of antihypertensive drugs, and diuretics, based on EGFR (estimated glomerular filtration rate). This is considered as a key component of hypertension management in CKD patients. Along with the drug treatment some non-pharmacological approaches including lifestyle modifications should also be included. It must be noted that the most important of these is dietary salt restriction. It must be included in the management of hypertension in CKD patients.

General Recommendations:  

• A DASH diet is helpful. 
• Smoking and Alcohol consumption should also be avoided as it makes a substantial difference in CKD progression. 
• Alcohol consumption by men should be restricted to not more than 30 ml per day in men and for women and lighter-weight persons to no more than one drink per day.
• Timely BP monitoring and timely kidney vitals follow-up should be managed.  

Also Read : Everything to know about protein in the urine

Ayurvedic View for Treatment

Modern science considers hypertension as a disease while Ayurveda considers it as the Prasaravastha of all the Doshas along with Rakta. Improper life-style and improper food habits along with psychological stress  like:

• Atichinta (excess worry), 
• Bhaya (fear), 
• Krodha (anger), 
• Alasya (dullness) etc., aggravates and vitiates all the three Doshas (Vata, Pitta and kapha) to trigger renal hypertension. 

Hypertension can also be read as a psycho-somatic hemodynamic condition in ayurveda. It occurs when Vata Pradhana Tridoshas are vitiated affecting the Rasa-Rakta Dhatus as Dooshyas for Sarva Shareera (whole body) and Manas (mind) as its Adhisthana (site). 

The Line of treatment along with rasayana chikitsa mentioned in ancient scriptures is:

• Nidana parivarjana means avoidance of aetiological factors. 
• Samshodhana chikitsa means Bio-cleansing therapies. 
• Samana chikitsa means Palliative therapy
• Lekhana Vasti 
• Virechana karma means purgation with Eranda taila (castor oil) 
• Shirodhara 
• Takra dhara 

It should be noted that the decision of selection of Dhara and its medicines should be taken under medical supervision. The effective management of hypertension includes lifestyle modifications, a special emphasis and if necessary appropriate drug therapy should also be given. There are many herbs available to help and treat hypertension and CKD like Sarpgandha, Arjuna, punarnava etc. These herbs should be taken under proper medical supervision. 

 Other Management approaches:

1. Consume fruits and vegetables 
2. Prefer vegetarian, low fat, low calorie diet.
3. Can use of garlic and onion in regular diet
4. Do physical exercises daily for 30 - 45 minutes
5. Reduce weight as required
6. Limit use of salt, fats and sweets
7. Avoid day sleep, anger, anxiety.
8. Avoid caffeine, alcohol and tobacco

Chronic kidney disease treatment in ayurveda

Ayurveda is an ancient Indian medical science practiced for ages. It teaches us the lessons of life used for managing our health ailments. Chronic kidney disease treatment in Ayurveda can help your damaged kidneys.