Healing Beyond Obstruction: Panchakarma's Role in Treating Hydrourureteronephrosis Leading to Chronic Kidney Disease

Abstract

Hydronephrosis and hydroureter occur secondary to obstruction of urinary outflow at the renal pelvis and ureter. These conditions are observed in all age groups. Timely diagnosis and management are necessary to prevent the long-term renal complications. Obstruction to the flow of urine, with attendant stasis and elevation in urinary tract pressure, impairs renal and urinary conduit functions and is common cause of acute and chronic kidney disease (obstructive nephropathy). Early recognition and prompt treatment of urinary tract obstruction can prevent or reverse devastating effects on kidney structure and function and decrease susceptibility to hypertension, infection, and stone formation. Chronic obstruction may lead to permanent loss of renal mass and excretory capability. Acharya Vagbhata made a significant contribution by classifying these conditions into two main categories Mutra Atipravritti Vikara, which refers to disorders characterized by excessive urination such as Prameha, and Mutra Apravritti Vikara, which includes conditions marked by obstruction or difficulty in urination, such as Asmari, Mutrakricchra and Mutraghata. This case study highlights the integrated role of Shodhana and Shamana in the management of chronic kidney disease (CKD). A patient presenting with Grade 4 hydronephrosis who had progressed to chronic kidney disease (CKD) was managed with Panchakarma treatment. This case study highlights the potential of Panchakarma’s Shodhana and Shamana in the management of chronic kidney disease (CKD) as a supportive therapeutic modality in advanced renal pathology.