Management of Madhumeha Janya Upadrava with special reference to diabetic nephropathy - A clinical study

BACKGROUND: Diabetic nephropathy (DN) is a microvascular complication of diabetes mellitus. As the disease DN manifests secondary to Madhumeha, the disease is termed as Madhumeha Janya Upadrava. The diagnosis of DN is microalbuminuria is a powerful screening tool in screening DN earlier stages. A diabetic can develop nondiabetic renal disease like anyone, but the finding of diabetic retinopathy strongly suggests that any proteinuria is due to diabetic glomerulosclerosis. In this dissertation, all diabetic patients who showed positive diabetic retinopathy changes; were screened for 24 h microalbuminuria, at its earlier asymptomatic period itself. This research work is specially intended to instigate effective therapies at earlier stage itself, thereby prevent further progression. AIM: To evaluate the combined effect of Shilajitvadi Vataka, Punarnavadi Mandura, Triphala Guggulu and Pippalimooladi Paneeya added with Amrita and Bringaraja in DN. MATERIALS AND METHODS: Single blind clinical study with pre-test and post-test was designed. The study conducted on 15 patients of both sex aged between 20 and 80 years, having DN changes through assays for microalbuminuria and other biochemical assays; along with prior confirmation of diabetic retinopathy changes. The duration of the study was 48 days and patients were assessed on every 15 days. RESULTS: After 48 days of treatment, statistically significant improvement in levels of microalbuminuria with mean difference 83.76 μg/24 h, highly significant improvement in status of Agni and statistically no significant improvement in glomerular filtration rate by 2.381 mL/min/1.73m(2). No significant side-effects were observed. CONCLUSION: Overall the study showed encouraging results in treating the malady DN.