Renal stone

Pathophysiology of Nephrolithiasis and its
Homoeopathic management
8/6/2017 1
Dr Md Shahriar Kabir, B H M S (DU),
LECTURER, CHRONIC DISEASE, CASE TAKING
& REPERTORISATION, GOVT
HOMOEOPATHIC MEDICAL COLLEGE,
Dr. Md. Shahriar Kabir
B H M S(DU)
Lecturer,
Chronic disease, case taking & repertorization ( G H M C, Dhaka)
Blog: microdoshomoeopathi.blogspot.com
E-mail: microdoshirok@gmail.com
Mobile: 01712966190

Contents
1.Bibliography.
2. introduction.
3. types of renal stones.
4. Calcium Nephrolithiasis.
5. The parathyroid glands and Calcium Nephrolithiasis.
6. Mechanisms .
7. Miasma .
8. Remedies .
9. Diet .
10. Some avoidable Drugs.
8/6/2017
2

Bibliography
1. Kumar & Clark, Clinical Medicine, fifth edition, chapter renal disease, page- (625-631).
2. Davidson’s Principle and Practice of Medicine, 19th edition, chapter kidney and genitourinary
disease, page- (632-634).
3.CURRENT Medical Diagnosis & Treatment, 35th edition, chapter urology, page-(833-837).
4. Pathophysiological Repertory for Nephrolithiasis, www.microdoshomoeopathi.blogspot.com,
Dr. md . Shahriar Kabir.
5. Lotus Materia Medica, Robin Murphy, ND, 2ND Revised edition.
6.Miasmatic Prescribing, Dr. Subrata Kumar Benejea, first edition.
7. Concordant Materia Medica, Frans Vermeulin, 2001, IBPP.
8. RADAR 10.
9. http://www.health.harvard.edu/blog/5-steps-for-preventing-kidney-stones-201310046721
10. http://www.nhs.uk/Conditions/Kidney-stones/Pages/Causes.aspx
11. http://www.renalandurologynews.com/kidney-stones/antibiotics-could-increase-kidney-
stone-risk/article/216934/
8/6/2017
3

Introduction
•Kidney stones, are solid masses made of crystals.
Kidney stones usually originate in your kidneys, but
can develop anywhere along your urinary tract. The
urinary tract includes the kidneys, ureters, bladder,
and urethra.
•Most stone occur in the upper urinary Tract.
•Most stones are composed of Calcium oxalate &
phosphate, these are more common in men.
• Stone disease frequently a recurrent problem.
More than 50% of patients with a calculus will have
formed a farther stone or stones with in 10 years.
• the ricks of recurrence increase if a metabolic or
others abnormality predisposing to stone formation
is present and is not modified by treatment.
8/6/2017 4

8/6/2017 5

calcium Nephrolithiasis
Hypercalcinuric calcium
Nephrolithiasis , can be
caused by:-
1. absorptive,
2. resorptive &
3. renal disorder.
8/6/2017
6

Absorptive
Absorptive
Hypercalcinuria is
secondary to increased
absorption of calcium at
the level of the small
intestine, predominantly
in the jejunum.
8/6/2017
7

Types
1. Non- dietary: this types of absorptive Hypercalcinuria is
independent of calcium intake, there is increased urinary calcium on
a regular or even calcium restricted diet.
8/6/2017
8

Cont ….
2. Diet dependent: this types of Hypercalcinuria
decreasing calcium intake by 50% (400 mg/d).
8/6/2017
9

Cont …
3. Renal phosphate leak: this results in increased
Vitamin D synthesis & secondarily increased small
bowel absorption of calcium.
8/6/2017
10

The parathyroid glands &
resorptive Hypercalcinuria
The parathyroid glands
are four tiny glands,
located in the neck, that
control the body's calcium
levels. Each gland is about
the size of a grain of rice
(weighs approximately 30
milligrams and is 3-4
millimeters in diameter).
The parathyroid's produce
a hormone called
parathyroid hormone
(PTH). PTH raises the
blood calcium level by:
8/6/2017
11

Cont ..
• breaking down the bone (where most of the body's
calcium is stored) and causing calcium release
• increasing the body's ability to absorb calcium from
food
• increasing the kidney's ability to hold on to calcium
that would otherwise be lost in the urine.
8/6/2017
12

Cont ..
• Normal parathyroid glands work like the thermostat
in your home to keep blood calcium levels in a very
tightly controlled range. When the blood calcium
level is too low, PTH is released to bring the calcium
level back up to normal. When the calcium level is
normal or gets a little too high, normal
parathyroid's will stop releasing PTH. Proper
calcium balance is crucial to the normal functioning
of the heart, nervous system, kidneys, and bones.
8/6/2017
13

Hyper- parathyroidism
• If your parathyroid gland is too big (enlarged),
it can cause your body to produce too much
parathyroid hormone (hyperparathyroidism).
This may lead to too much calcium in the
urine, which makes it more likely that you will
have calcium kidney stones.
8/6/2017
14

Mechanism
• Oxalate is a naturally occurring substance found in
food. Some fruits and vegetables, as well as nuts
and chocolate, have high oxalate levels. Your liver
also produces oxalate. Dietary factors, high doses of
vitamin D, intestinal bypass surgery and several
metabolic disorders can increase the concentration
of calcium or oxalate in urine. Calcium stones may
also occur in the form of calcium phosphate.
8/6/2017
15

Cont ..
• Urinary supersaturation (reduce solibility) is the
driving force behind crystal formation in the
kidneys. Since formation of crystalline particles
must obviously start from supersaturation,
supersaturation is undoubtedly essential for stone
formation.
8/6/2017
16

Crystallization
• In tubular fluid and urine, crystallization processes
are largely dependent on solution composition. A
variety of urinary constituents may affect solution
supersaturation because of their activity. For
instance, by forming soluble complexes with
calcium and oxalate, respectively, citrate and
magnesium reduce free ion activity and the relative
supersaturation of calcium oxalate.
8/6/2017
17

Crystal nucleation
• renal tubular cell injury can promote crystallization
of CaOx crystals by providing substances for their
heterogeneous nucleation. In vitro cell degradation
following renal tubular cell injury produces
numerous membrane vesicles, which have been
shown to be good nucleators of calcium crystals. In
vivo crystals observed in the renal tubules of
hyperoxaluric rats are always associated with
cellular degradation products
8/6/2017
18

Crystal growth
• the crystal surface binding substance, which is
found in CaOx crystals generated from whole
human urine, is a strong inhibitor of CaOx crystal
growth and contains human serum albumin, α1-
acid glycoprotein, α1-microglobulin, 2-HS
glycoprotein, retinol binding protein, transferrin,
Tamm-Horsfall glycoprotein, and prothrombin
8/6/2017
19

Sycotic Miasma
• Renal calculi & calculous deposits in others parts of
the genito-urinary tract.
• Calculi, complication of the genitourinary tract &
various pains of the urinary tract.
• Glandular, Hormonal & Metabolic disorder.
8/6/2017
20

Some remedy which have oxalate
in urine
1.Adrenalinum
2. Arania diadema
3. Berbris vulgaris
4. Calcaria phosphorica
5. Causticum
6. Kalium sulphuricum
7. Lysidinum
8. Nitricum acidum
9. Natrum muriaticum
10. Nitro muricum acidum
11. Natrum phosphoricum
12. Oxalicum acidum
13. Senna
14. Terebinth
8/6/2017
21

Calcaria phosphorica
1. Affects the nutrition of bones and glands.
2. Bone become soft, thin & brittle.
3. Rheumatism, malassimilation.
4. Tendency to glandular enlargement.
5. Pain in region of kidneys worse blowing nose or
lifting.
6. Pain in bladder when empty.
8/6/2017
22

Berberis vulgaris
1. Old gouty constitution.
2. Tendency to formation of calculi.
3. Severe pain from kidney stone. (bubbling pain in
the region of kidneys).
4. Radiating pains from kidney to bladder.
5. Pain in the thighs and loins on urination
8/6/2017
23

Adrenalinum
1. Increase glandular activity.
2. The main action of the Adrenalin is stimulation of
the sympathetic ending, causing constriction of the
peripheral arterioles ( vasoconstrictor).
3. A most powerful haemostatic.
4. Crystals of sodium oxalate increase in urine.
8/6/2017
24

Nitro muric acid
8/6/2017
25
1. oxaluria.
2. Aching in hip, thighs & small of back after a short
delay some pale urine passed.
3. Burning in urethra.

Aranea diadema
1. Acute glomerulonephritis.
2. Nephrotic syndom.
3. Urine strongly yellow in color.
4.Strong smell of ammonia in the urine.
5. proteinuria.
6. oxalate, urate & phosphate crystals present.
8/6/2017
26

Calcaria renalis
1. Lessen tendency to accumulation of tartar on
teeth, gravel & renal stones, bladder stones.
2. Arthritic nodosities, gout.
8/6/2017
27

Diet
Drink plenty of water
Get the calcium you need
Reduce sodium
Limit animal protein
• Avoid stone-forming foods: Beets, chocolate,
spinach, rhubarb, tea, and most nuts are rich in
oxalate, and colas are rich in phosphate, both of
which can contribute to kidney stones .
8/6/2017
28

Some avoidable drugs
• aspirin
• antacids
• diuretics (used to reduce fluid build-up)
• certain antibiotics (Antibiotics can decrease colonization of a common
intestinal bacterium that metabolizes oxalate, perhaps rendering patients more
susceptible to the formation of calcium oxalate kidney stones, according to
researchers.
• The bacterium, Oxalobacter formigenes (OF) is a commensal organism that
colonizes the human colon in a large proportion of the normal adult
population. OF bacteria metabolize oxalate as their sole energy source. By
decreasing the availability of dietary oxalate for absorption , these bacteria
could lower the risk of hyperoxaluria and thus prevent development of calcium
oxalate stones.
• certain antiretroviral medication (used to treat HIV)
• certain anti-epileptic medication
8/6/2017
29

8/6/2017
30

Renal stone

Recommended

Recommended

More Related Content

More from Dr md shahriar kabir

More from Dr md shahriar kabir (11)

Recently uploaded

Recently uploaded (20)

Renal stone