It is therefore difficult for PCPs to plan an appropriate follow-up after hospital discharge.
Despite ongoing public alerts about essential dietary controls and exercise requirements for maintaining health, there is heavy reliance on risk-reducing and disease modifying drugs as well as surgical interventions for dealing with the adverse impact of modern lifestyle problems.
Renal failure also occurs as the result of systemic autoimmune disorders e. Except for cases of temporary decline in renal function that may occur from several causes, kidney disease is usually progressive once a significant fraction of nephrons are damaged, and the disorder becomes end-stage renal disease ESRD.
A summary of the incidence and primary causes of ESRD have been monitored and reported. Here are the basic statistics showing the increasing frequency of ESRD and the primary causes 2: Incidence annual new cases of ESRD: Most patients are treated by in-center hemodialysis, and to a much lesser extent via other dialysis techniques, and then, when possible, by kidney transplant.
The first hemodialysis center was established in Seattle in and this method became routine in the U. According to the Annual Report of the Organ Procurement and Transplantation Network 3the kidney transplant waiting list more than doubled in the decade from and to over 50, and reached 79, by the end of The number of kidney transplants performed in the U.
The combined number of those on waiting lists, those who receive transplants, and those in need of transplants but not on the list, now comes to aboutper year.
Both kinds of transplants require immunosuppression, but matched family donors can provide organs that need minimal suppression. Nonetheless, some patients desire assistance with herbs and other natural therapies.
An herb of interest is salvia Chinese: Inan article in the Shanghai Journal of Traditional Chinese Medicine reported on this application 4. InJapanese researchers reported on isolation of a constituent of salvia responsible for promoting renal function, which was identified as lithospermate B 5.
This ingredient, like the whole root of salvia, was reported to enhance plasma blood flow and reduce glomerular filtration rate in the kidneys of laboratory animals suffering renal failure; it was later shown to be of potential benefit for diabetic nephropathy 6 and for improving renal microcirculation 7.
InChinese researchers in Hangzhou reported on the effect of salvia injection in patients undergoing peritoneal dialysis for renal failure, claiming it could markedly increase the clearance rate and ultrafiltration rate of creatinine, urea nitrogen, and uric acid 8. A study in Japan published in further noted that salvia inhibited nitrogen oxide NO production which was thought to be a contributor to both acute and chronic renal failure 9while a study in Korea published in suggested that scavenging of free radicals was part of the mechanism of action for both salvia and its component lithospermate B 10 Salvia has also been used in the treatment of patients who have undergone organ transplants to help prevent rejection and aid longevity of the transplants.
Pharmacological studies appeared to confirm the value of this application A review of its use in renal transplant patients was published in Claimed benefits included improvement in nearly all blood parameters that monitor renal function, improved recovery from the transplant, and better protection of the kidney.
In a summary statement, the authors noted: According to TCM theory, many symptoms of patients after renal transplantation belong to the category of blood stasis. In observing the effect of salvia in treating acute vascular rejection after renal transplantation Wu Kun et al.
The total therapeutic course was 14 days. Results showed that the levels for all seven parameters were significantly improved in both groups. Comparisons between the effects in the two groups showed that the results for the treated group were superior to that of the control group in the total effective rate and in the improvement of the levels of NAGase and DD.
The authors concluded that salvia could enhance the curative effect of methylprednisolone impulse in controlling acute vascular rejection. Further study showed that DD, as the simplest degradation product of fibrin monomers, increased in vascular rejection, suggesting that a hypercoagulative state and hyperfibrinolysis might affect the microcirculation of the allograft and result in microthrombus formation in the allograft.
NAGase is a renal tubular lyosomal enzyme; increase in its activity reflects the damage to the renal parenchyma. Salvia treatment could reduce the titer of the two parameters, the mechanism is related to its effects in regulating capillary tension, improving hemorrheological properties, impacting activity of fibrinolysis, suppressing platelet aggregation, reducing blood viscosity, inhibiting the excessive expression of nitrogen monoxide NO and peroxide, and improving microcirculation, and thus improving function of the transplanted kidney.
Huang Zufa, et al.
Herbal therapies were devised to treat patients with early renal failure. The common ingredient in virtually all the treatments was rhubarb root; it could be used alone, but was usually incorporated into formulas, and it might be given by retention enema, IV injection, or in decoctions given orally.
A difficulty with rhubarb treatment is that it usually produced loose stool or diarrhea. This method of treatment persisted into the s, but is used less now that dialysis and transplantation are available. Still, it is worth investigating, because low to moderate doses of rhubarb may provide some benefits.
The traditional medicine rationale for using rhubarb in treatment of patients with renal failure is that the disease is marked by an underlying condition of deficiency which allows the deterioration and an overlay of excess, namely stagnation of blood and accumulation of damp and turbidity.
Rhubarb is applied to address the excess through its purgative and diuretic qualities, as well as its blood-vitalizing activity. While alleviating this secondary condition, therapies for the underlying deficiencies might be applied, relying mainly on tonic formulas that address the specific types of deficiency e.
In a study published in 13patients with chronic renal failure were treated by traditional Chinese medicine according to standard methods of differential diagnosis; tonic formulas selected accordingly, but each prescription was also accompanied by rhubarb, with 8—12 grams in a daily decoction.Failure to manage both dietary elements is the single most common cause of flare-ups in congestive heart failure patients.
Unfortunately, there is a cataclysmic disconnect between the provision of ‘good counsel’ and proper follow-through. In patients with acute liver failure, this type of support is provided as it is for other critically ill patients, with specific caveats.
Patients with acute liver failure are at increased risk for hypoglycemia, which can be prevented by an intravenous glucose infusion.
Owners of Holden Captivas with diesel engines, however, have reported that failure of the needle roller bearings can cause damage to the camshaft, the hydraulic lifters and send metal pieces into the cylinders, thereby jamming the pistons.
At worst, failure of the needle roller bearings can result in the engine needing to be replaced. Postpartum cardiomyopathy (PPCM) is a rare condition that develops near the end of pregnancy or in the months after giving birth, manifesting as heart failure secondary to left ventricular systolic dysfunction.
Acute Liver Failure from Herpes Simplex Virus in an Immunocompetent Patient Due to Direct Inoculation of the Peritoneum. Download PDF. Dhruv Chaudhary, Fink CG, Read SJ, Hopkin J, Peto T, Gould S, Kurtz JB. Acute herpes hepatitis in pregnancy. Last Review Date: 09/13/ CG-MED Medical and Other Non-Behavioral Health Related Treatments for Autism Spectrum Disorders and Rett Syndrome; is usually indicated when there are new significant clinical findings, a rapid change in individual’s status, or failure to respond to occupational therapy interventions.
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