Chronic kidney disease is defined as kidney damage or a decreased kidney glomerular filtration rate of less than 60, for 3 months or more, irrespective of the cause. This results in a progressive decline in kidney function, resulting in accumulation of toxic waste products, excess water and salts, increased blood pressure, anemia and many other complex symptoms. Chronic renal failure is divided into Stages I - V, out of which the first three stages are asymptomatic, and usually discovered incidentally, while doing routine blood tests.

The cause for ARF is as follows:

• Reduced blood supply to the kidney as a result of trauma, surgery

• Heavy bleeding

• Septic shock

• Acute dehydration

• Burns

• Infections

• Rarely acute tubular necrosis

Symptoms:

Initially, during the first week of the disease, the signs and symtoms are of the primary disease, i.e. acute GN, dehydration, etc., and the patient starts passing less urine than normal. If the condition remains undetected, i.e. specific attention is not paid, or the patient does not report to his physician about the low output of urine, the vital period for saving the kidneys is wasted, and the volume of urine passed daily goes ondecreasing till it becomes less than 400 ml, when an acute kidney failure is said to have been initiated.

Here are some of the pointers that are being focused on the acute renal failure treatment:

- Nutritional needs are also determined by the treatments that are used by the patient such as dialysis. Another determinant of nutrition and diet is the cause of ARF. There are generalized variations in patients who have trauma, burns, or infections to those who had ARF caused by other diseases.

- In cases where dialysis is not a treatment option, protein should be regulated to 0.6 grams per kilogram body weight. While this is a well accepted value, it should not exceed more than 40 grams on any person.

- During the oliguric phase, sodium salt might be restricted to 1000mg to 2000mg and potassium to 1000 mg per day. These are two of the most vital electrolytes that the body needs and they may be lost during the period of frequent urination.

Traditional Ayurvedic medicines which are useful in chronic renal failure are: Gokshuradi Guggulu, Punarnava Guggulu, Punarnavadi Qadha(decoction), Arogya Vardhini, Chandraprabha Vati, Gomutra Haritaki, Surya Kshar and Yava Kshar. Single herbal medicines useful in this condition are: Gokshur (Tribulus terrestris), Punarnava (Boerhaavia diffusa), Shilajit (Purified Bitumen), Varun (Crataeva nurvala), Apamarg (Achyranthus aspera) and Haritaki (Terminalia chebula).

Renal diet is a highly recommended diet for patients having renal problems. It is estimated that only 25% of the total number of nephrons are necessary to maintain healthy renal function. That means that the renal failure system is well protected from failure with a large backup system.

Dietary intake of electrolytes may be encouraged or restricted. The regulation of sodium is a delicate matter. At times, the kidneys waste salt, and sodium intake must be encouraged to replace it. More frequently however, the kidneys retain sodium. Some believe that there should be moderate restriction with careful monitoring of urinary sodium as guideline.

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