Hepatorenal Syndrome (HRS) is the development of renal failure in patients with advanced, chronic liver disease who have portal hypertension and ascites. Common signs and symptoms include a decreased urine output, a decline in renal function and all the symptoms of chronic liver disease. Patients with liver disease who have a low arterial blood pressure, reduced sodium levels in the blood and severe urinary sodium retention have a high risk of renal vasoconstriction, which ultimately results in renal failure.
The Ayurvedic treatment of HRS is aimed at treating both the liver disease and the kidney failure. Medicines like Gokshuradi-Guggulu, Punarnavadi-Guggulu, Punarnavadi-Qadha, Gomutra-Haritaki, Chandraprabha-Vati, Saarivadi-Churna, Mahamanjishthadi-Qadha, Punarnava (Boerhaavia diffusa), Gokshur (Tribulus terrestris), Haritaki (Terminalia chebula), Erandmool (Ricinus communis), Haridra (Curcuma longa), Daruharidra (Berberis aristata), Ikshumool (Saceharum officinarum), Saariva (Hemidesmus indicus), Deodar (Cedrus deodara), Apamarga (Achyranthus aspera) and Sahinjan (Moringa pterygosperma) are used to treat kidney failure.
Medicines like Arogya-Vardhini, Shankh-Vati, Sutshekhar-Ras, Suvarna-Sutshekhar-Ras, Kutki (Picrorrhiza kurroa), Kalmegh (Andrographis paniculata), Devdangri (Luffa echinata), Bhrungraj (Eclipta alba), Bhumiamalaki (Phyllanthus niruri), Sunthi (Zinziber officinalis), Amalaki (Emblica officinalis), Guduchi (Tinospora cordifolia), Swarjika-Kshar and Surya-Kshar are used to treat the liver disease. Medicines acting on the ‘Rakta’ and ‘Meda’ dhatus (tissues) act equally well on both liver and kidney diseases. These medicines include Patol (Tricosanthe dioica), Patha (Cissampelos pareira), Musta (Cyperus rotundus), Chirayta (Swertia chirata) and Chandan (Santalum album).
All patients suffering from HRS should be kept predominantly on milk. The Ayurvedic treatment of severe liver disease along with ascites is repeated, induced purgation. Medicines like Jaipal-Ras and Icchabhedi-Ras are given for this purpose. This treatment reduces fluid in the peritoneal cavity and also brings about hepatocellular recovery to some extent. Because of purgation, it also reduces the load on the kidneys, increases the blood supply to the kidneys and thereby helps in the recovery of the kidneys too. A strict watch has to be kept on the circulatory volume of the patient in order to avoid severe volume depletion and circulatory collapse. A soup prepared from goat intestine also helps in rapid improvement of kidney function. Medicines like Arogya-Vardhini, Sutshekhar-Ras, Gokshuradi-Guggulu and Gomutra-Haritaki need to be given long-term in order to stabilize the functions of the liver and kidneys and prevent a relapse.
HRS is a serious disease with a potentially high fatal outcome. Rapid and progressive kidney failure is best treated in an intensive care unit. All such patients should be under the regular care and supervision of a team of specialists including a Hepatologist and a Nephrologist. Ayurvedic treatment can be given as additional therapy in order to bring about faster therapeutic results and improve the chances of survival.