Nephrological Diseases

The kidneys are situated posteriorly in the abdomen, one on each side of the spinal column behind the peritoneum, and extend from the level of the eleventh rib to near the crest of the ilium (the right one is lower than the left). The function of the kidney is maintenance of the homeostatic balance of body fluids by filtering and secreting metabolites from the blood and secreting them along with water forming urine.
The urine must be tested for any diseases, its specific gravity, odor, color, reaction, albumin, picric acid, sugar, bile, urea, chlorides, sulphates, phosphates, alkaline etc. for investigating normal /abnormal function.
So vital is the function of kidneys for maintenance of our life processes that any diseases or dysfunction in it can be fatal for us. Some of the common nephrological diseases found in our clinical practices are:

Movable and floating Kidneys: Nephrotosis, floating Kidneys is a congenital condition. It is more common in women than in men. The patient often complains high degree of nervousness.
Treatment: Ignatia, Nux vom., Strychnia, Arsenicum, Cinchona and Pulsatilla

Poly cystic kidney:  It is frequently congenital, and may be associated with club-feet and hare-lip. It is usually multilocular. The cavity is filled with fluid or a colloid material which contains no urea. In some cases no renal tissue can be recognized.
Symptoms – The organ may attain such a size during fetal life as to interfere with delivery. If the child is born alive; the renal tumor is so large that death soon results
Treatment: It is surgical, the cysts may be punctured.

Hyperaemia – it may be the first stage of inflammation of kidney. The kidney is enlarged, of a dark red color and blood drips from a cut surface .
Treatment:
Aconite if the patient is restless, thirsty and there is anxiety and fever
Veratrum viride, Cantharis –when there is constant desire to urinate.
Berberis vulgaris is indicated when it is painful.

Chronic Nephritis: This presents it self either in the form of chronic parenchymatous nephritis which is a diffuse process. This is an inflammation affecting all tissues of the renal cortex but not tending to suppuration. Primarily the kidney is enlarged as a result of inflammation.
Treatment:
Apocynum cannabinum- in which dropsy is pronounced.
Cantharis the urine is highly albuminous, micturition is frequent.
Mercurius corrosives - this remedy should be followed after Cantharis - the patient may be anemic. He may have gastro-intestinal disturbance.
Arsenicum album-when the patient complains of extreme weakness and prostration, there is restlessness and anguish.
Chronic interstitial nephritis: This is a process of fibrosis usually associated with diffused arterioslerosis and a parenchymatous degeneration that results in contraction of the size of the kidney.
Treatment:
Aconitum-- will be found of service in relieving the cerebral congestion and vertigo.
Mercurius solubilus –if there is a history of syphilitic infection. The urine contains albumin and casts.
Arsenicum album—when there is respiratory difficulties, dyspnoea which is worse after midnight.
Post scarlatina nephritis: It is a similar condition encountered secondary to other infectious diseases. The danger of the excretory power of the kidney being injured.
Treatment:
This is similar to the management of acute nephritis. Aconite, Apis mellifica Cantharis should be tried.
Suppurative Nephritis: abscess of the kidney and acute nephritis. There is pain in the region of the kidney increased by pressure. The urine is diminished in quantity
Treatment:
During the early stages  Aconite or Veratrum viride ,
If the fever is high Arnica with history of traumatism.
Following the drainage, Silicea, Hepar sulphur, Calcarea, Echinacea should be compared.

Pyelitis: Surgical pyelo-nephritis. This is inflammation of the pelvis of the kidney. It may be catarrhal, hemorrhagic or purulent in character.
Treatment:
In acute cases when the fever is high and the pain is severe  Aconite ,or Veratrum viride .
When the dry skin has given way to a moist hot skin with throbbing and dilated pupils –Belladonna,
If the patient becomes restless – Rhus tox
If blood in the urine –Cantharis,
If the case has advanced –Berberis vulgaris
If it has a large percentage of pus –Benzioc acid.

Urocystitis:  Inflammation of the urinary bladder. This is frequently caused due to bacteria, as the streptococcus, staphylococcus and bacterium coli. The mucus membrane of the urinary bladder may show redness, swelling and an increased secretion of mucus.
Treatment:
In acute cases one of the following remedies –
Terebinthina - is useful when the urine is scanty and bloody, 
Cantharis –this is indicated when there is a constant desire to urinate,
Aconite, Belladonna, Hyoscyamus – when the fever is high.

Tuberculosis of the kidney: The direct cause is the tubercle bacillus. The predisposing cause is an inherent or an acquired weakness of the kidney. The urine sooner or later contains pus and blood and may be alkaline in reaction.
Treatment:
Tuberculin in infrequent doses is of great service in increasing the resistance. Calcarea carb, Calcarea phos, and Calcarea iod are useful.

Nephrolithiasis: Renal calculus; stone in kidney. This disease is more common in males than in females. The excessive use of meat and alcohol and disorders of metabolism, as gout, favor development of stones.
Treatment:
Surgical methods or homoeopathic medicines such as Sarsaparilla , Berberis vulgaris , Benzoic acid, Lycopodium, Chelidonium and Sepia may be tried .

Hematuria:  This is Renal epistaxis, the presence of blood in the urine when the red blood corpuscles can be demonstrated. It occurs as a result of acute nephritis, embolism of the renal artery, carcinoma of the kidney, renal tuberculosis, renal calculus and injury to the kidney.
Treatment: Geranium maculatum, Thalspi bursa pastoris , Cantharis, Ipecac, Crotalus and Lachesis

Albuminuria: Cases in which albumin has appeared in the urine during a life time without any pronounced or injurious effects, yet its presence is looked upon as a morbid manifestation. Albuminaria may be the result of primary disease of the kidney.
Treatment:
All food, drink and any condition that will in any way lead to an irritation of the kidney should be avoided. A milk diet is especially beneficial. Vegetables and light pastry may be used. Exercise should be taken in moderation.

Anuria: This is a condition in which there is no urine voided. It may result from retention of urine within the bladder. The use of the catheter can differentiate from partial retention of urine.
Treatment:
Aconite , terebinthina and cantharis, if there is renal congestion and inflammation .
Apocynum if there is dropsy.
Glonoine  if there is evidence of heart ailments .

Hemoglobinuria: This is a condition in which the coloring matter of the blood appears in the urine, it is most commonly either of a chemical or bacterial origin. Urine is of bloody appearance but no red blood corpuscles are found.
Treatment: The remedies that have been of most service are Crotalus, Phosphorous and Ferrum phos.

Phosphaturia: In this there may be a condition in which the earthly and alkaline phosphates are constantly and abnormally eliminated.
Treatment: Phosphoric acid is usually sufficient to control the disease.

Oxaluria:  When there is abundance of the oxalate of lime crystals in the urine.
Treatment: Oxalic acid , Nitromuriatic acid , Berberis vulgaris and Senna are those most frequently indicated .

Cystoplegia: Paralysis of the bladder. Paralysis may involve the sphincter or the detrusor muscle of the bladder. It require most powerful effort to expel the urine .
Treatment:
The remedies are –Arsenicum , Causticum , Gelsemium , and Nux vomica .
Where the urine is retained, Aconite , Cantharis , Pareira brava and Terebithina

Cystospasms: Spasm of the urinary bladder, this may be purely a nervous disturbance or it may result from an anatomic alteration, as disease of the bladder, spinal cord or brain
Treatment: During the spasm the patient should take a hot hip bath and pass urine.
Cannabis indica –when there is spasm of the bladder,
Cantharis –spasm of the bladder and the urethra, Asafetida, Uva ursi, Salix nigra.

Nocturnal Enuresis: This is a disease of childhood. This consists of an unconscious evacuation of the urine in bed during profound sleep. It may be the result of defective education; it is natural condition of infancy and is usually overcome by correct training such as waking the child at night.
Treatment: The diet and training of the child should be regulated. Sulphur, Belladonna, Equisetum, Benzoic acid, Ignatia, Calcarea carb, Causticum, Pulsatilla, Gelsemium, Verbascum, Plantago, Phosphoric acid, Sepia, can be used depending upon the symptoms

Hyperesthesia of the bladder:  This is observed in hysterical, hypochondriac and nervous patients, who have been addicted to alcoholism, venereal excesses, mental over exertion, excessive indulgence in tobacco and masturbation. Patients complain of severe vesical tenesmus when the bladder contains but a few drops of urine.
Treatment:
Stigmata maydis-- is frequently of service,
Triticum repens, Salix nigra, Hyoscyamus and Camphor.

Malignant growths of the kidney:  They may be sarcoma or carcinoma and may be either primary or secondary. Men are more frequently affected than women. Complications, as rupture into the abdominal blood vessels, may cause death.
Treatment: Early operation might be of some service. Internal treatment may relieve some of the distressing symptoms, early nephrotomy may be considered, but is of little avail.

Carcinoma of the urinary bladder: This is uncommon, more frequent in women than in men and is commonly secondary to a similar condition of the uterus, prostate gland or testicle. It may undergo degeneration and carcinomatous ulcers develop. The true nature of the condition may be concealed for a long time, but the development of a chronic cystitis in an elderly person.
Treatment: Treatment has not been successful, but early operation is known to relieve pain and distress temporarily.

Aneurism of the renal artery:  This is rare and is seldom recognized during life. The patient dies suddenly, and a post –mortem examination shows a rupture of the renal artery. There is a tumor with an expansible pulsation palpable in the line of renal artery. Renal colic as from renal calculus with hematuria are the symptoms usually complained of.
Treatment:  is unsatisfactory

Amyloid Kidney: This is a degeneration of the kidney, the result of chronic wasting discharge or cachectic conditions of the body
Treatment: The early control of suppuration, or whatever factor is operative in the case is important. Potassium or Sodium , Arsenicum , the iodides should be compared . If the kidneys have undergone an interstitial degeneration, Aurum mur, and the various forms of mercury should be compared .
If tuberculosis is the causative factor Tuberculin, Phospophorus, Calc.carb. Calc.phos should be tried.