Minimal change nephrotic syndrome in my child this question feed

khargamohan, 13 July 2016 13:12

Sir, is curable in your Ayurveda?

My son is suffering since last 9 years

Details:- Visit Date : 15-Jun-2013 Address : KALANKI SUNAKARI MARG KATHMANDU BAGMATI DIAGNOSIS : NEPHROTIC SYNDROME - FREQUENT RELAPSER IN REMISSION
RENAL. BIOPSY - MILD MESANGEAL HYPERCELLULARITY HISTORY Eight year old Ashish, a known case of Frequently relapsing nephrotic syndrome who was sent home on tapering steroids in May 2010 was brought back for review after 3 yeas. During this period, he has continued to have frequent relapses and has not been off steroids at all. When brought here he was on prednisolone 40 mg daily. ON EXAMINATION Alert and afebrile. Weight was 21.6 kg and height 125 cm - both between 3rd and 50th centile. Blood pressure 80/58 mmHg. No cushingoid features. RS: Clear. CVS: S1S2 heard normal. No murmur. P/A: Soft. Liver and spleen not palpable. INVESTIGATIONS 24-Apr-2010 PLATELET COUNT 258000 CC.MM
24-Apr-2010 PT WITH INR
PATIENT 10.9 SECS
NORMAL RANGE 11.1-14.5 SECS
INR 0.95
24-Apr-2010 APTT
PATIENT 33.5 SECS
NORMAL RANGE 28.1-39.7
06-May-2010 PROTEIN TOTAL 7.9 g%
21-Apr-2010 PROTEIN TOTAL 6.8 g%
06-May-2010 ALBUMIN 4.2 g%
21-Apr-2010 ALBUMIN 4.0 g%
21-Apr-2010 CREATININE 0.5 mg%
06-May-2010 CHOLESTROL - TOTAL 219 mg%
22-Apr-2010 CHOLESTROL - TOTAL 294 mg%
06-May-2010 URINE PROTEIN/CREATININE RATIO PACKAGE
URINE PROTEIN 13 mg/dl
URINE CREATININ 260 mg/dl
UP/UC RATIO 0.050
21-Apr-2010 URINE PROTEIN/CREATININE RATIO PACKAGE
URINE PROTEIN 8 mg/dl
URINE CREATININ 93 mg/dl
UP/UC RATIO 0.086
21-Apr-2010 C3C C4
C3 C 134 mg/dl
C4 26.8 mg/dl
21-Apr-2010 ANA NEGATIVE
24-Apr-2010 RAPID HIV NEGATIVE
24-Apr-2010 RAPID HBSAG NEG CONF
24-Apr-2010 ANTI-HCV-RAPID ONLY NEGATIVE
03-May-2010 CMC - SPECIALISTS BIOPSIES 14252/10
Renal biopsy, mild mesangial hypercellularity. Mayank Gupta & Marie Therese Manipadam

DISCUSSION When seen here the child was no in remission hence the dose of prednisolone was increased to 60 mg/m2. When he went into remission, a plan for tapering steroids was made and MMF was added in view of frequent relapses. A letter was given to the parents to contact Dr. Rachel Sunderraj at Tanzen hospital in Kathmandu. RECOMMENDATIONS Tab. Prednisolone 50 mg alternate day x 2 weeks 40 mg alternate day x 2 weeks 30 mg alternate day x 2 weeks 20 mg alternate day x 2 weeks 15 mg alternate day x 1 month 10 mg alternate day x 1 month 5 mg alternate day x 1 month Tab. MMF 250 mg x 3 days 250 mg - 0 - 500 mg x 3 days 500 mg twice daily x 3 months - to be given for 2 years To follow with Dr. Rachel Sunderraj at Kathmandu and review in CMC if necessary
More: Nephrotic
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Doctor's Ayurvedic Advice:-

Diffuse proliferative hypercellularity is a primary proliferative glomerulonephritis with idiopathic nephrotic syndrome. Generally kids with nephrotic syndrome having minimal changes respond well to the medicines. Steroids, immunosuppressants and ACE inhibitors will be commonly used. Please continue with the medicines advised to avoid complications. Sometimes there will be steroid resistant or steroid dependance based on the pathological changes. Ayurvedic medicines can be given as supportive medicines to improve the function of the kidney.

Ayurvedic medicines like Punarava aristam - 10ml after food twice daily and Divya Chandraprabha Vati can be taken for a month and then reviewed.

Include berries, cucumber, gokshura, coriander, barley and turmeric. Reduce excess oil salt, diary products, meat and protein. Please continue with the checkups as advised by your nephrologist.

posted by Dr.Ramani on 19 July 2016

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