Clinical Case History
Introduction: I successfully managed a case of chronic kidney failure (diabetic nephropathy) having severe Left Ventricular dysfunction, LV ejection fraction (EF: 25-30%) and insulin-dependent diabetes mellitus (DM). His schedule for haemodialysis was two times per week. He stopped his dialysis (against the medical advice) just within 3 months of homeopathic treatment. His kidney Function Tests (KFT) remained within a normal range for the last 2 years. Though he has recovered from chronic renal failure yet the diabetes and cardio-myopathy are still active there. Though Pulsatilla is still effective, he is in risk without pacemaker implantation because of permanent damage to Aortic, Mitral and Tricuspid valves.
Case History: 58 year old man, Mr. K.arrived on 1 March 2016 with the complaint of constantly deteriorating KFT, his S.cr. was 12 mg/dl (normal range 0.6 to 1.2 mg/dl) before starting of dialysis. His pre-dialysis S.cr. maintained at a level of 9 -10 mg/dl. He was working as an office-assistant, where he had to sit at one place continuously for hours. He had been suffering from breathlessness and palpitation since a long time. Once he did moderate physical work and noticed increased palpitation and breathlessness. After this incident, he was kept under close observation of a cardiologist. His Echo-cardiography report was…
Sep.2014: Left Atrium (LA) and Left Ventricle (LV) was dilated, Mitral regurgitation, mild Aortic and Tricuspid regurgitation; Hypokinesia of the mid-septal segment; EF was 43%.
6 July 2015: Under one year of proper conventional treatment with no improvement in LV functions, there was global hypokinesia of LV detected. Deteriorating EF was 34%.
Ultra-sonography of kidneys on 6 March 2016: Right kidney size 120mm x 64mm; Left kidney size 117mm x 52mm with increased echogenicity. Three months (Dec.2015) ago when he went to his cardiologist for a routine check-up, a rise in S.cr. level was detected that was 1.9. Then a thorough check-up of his kidneys was done by a nephrologist at Agra. Despite taking proper treatment, KFT deteriorated day by day. S.cr. reached to 7.73, and then haemodialysis started from the right jugular vein, dialysis twice per week from 13 Feb 2016.
He had already been suffering from Diabetes Mellitus type 2 (Insulin dependent) since 2002. He was already taking oral anti-diabetic medicines. His blood sugar reading was as follows – Fasting >200 and PP >350 mg/dl. He was taking medicines for his cardiac problem also.
Family history for tuberculosis is positive. Nearly 12 years back his younger brother had been treated by me for fits caused by a tuberculoma in right cerebrum hemisphere. A few other family members have also been suffering from Tuberculosis for a long time.
1 March 2016: Tuberculinum 200c one dose was given. He felt much better in all his complaints except blood reports. Pre-dialysis S.cr. was 11.4.
12 March 2016: AV-fistula was made in his left arm. One antibiotic and anti-inflammatory medicines were added by his cardio-vascular surgeon.
16 March 2016: Complaints of (c/o) fever with mild chilliness, thirsty, constipation, jerking started once again. Pain and uneasiness at the site of AV-fistula; he was continuously touching it gently by his hand. Phosphorus 30c one dose was given after repertorisation
[Complete ] [Mind]Weeping, tearful mood:Tendency:Sad:Thoughts, at:
[Complete ] [Generalities]Bathing, washing:Aversion to, dread of:
[Complete ] [Generalities]Food and drinks:Milk:Desires:Cold:
[Complete ] [Generalities]Food and drinks:Cold:Drinks, water:Desires:
[Complete ] [Generalities]Food and drinks:Sweets:Desires:
[Complete ] [Generalities]Food and drinks:Eggs:Desires:
[Complete ] [Generalities]Food and drinks:Salt or salty food:Aversion:
[Complete ] [Extremities]Jerking:Sleep:Agg.:Falling asleep, on:
[Complete ] [Generalities]Rubbing, massage:Amel.:Hand, with:
[Complete ] [Head]Heaviness:Evening:
[Complete ] [Stomach]Thirst:Large quantities, for:
[Complete ] [Stomach]Nausea:Food:Thinking of:
No > in pain, but he felt little better in fever, nausea, and jerking; now having no constipation with better urine output.
23 March 2016: c/o rise in fever again with chill < evening until morning, pain at the site of Fistula not relieved by painkiller; pre-dialysis S.cr. was 10.09. Phosphorus 30c one more dose. Again, he felt much better.
26 March 2016: Pain at AV fistula because of pus in the wound; fistula had become failed. A desire to rub gently over the wound to get relief of pain; high BP; again, raised body temp. to 101F; vomiting on every attempt of drinking or eating; again, constipation and reduced urine output; vertigo < dialysis after. He was not getting any relief by pl (placebo).
27 March 2016: No relief at all; there was fever without thirst. Pulsatilla (Puls) 30c one dose worked immediately. One more dose was repeated on 28th March.
29 March 2016: >> in almost every symptoms
30 March 2016: S.cr. – amelioration in most of the symptoms. Pre-dialysis S.cr. was 7.97
8 April 2016: Pre-dialysis S.cr. was 7.97. Headache after dialysis < evening; he was fed-up with dialysis. He requested me by phone to save him. Puls 30c one more dose helped him a lot.
14 April 2016: c/o of vomiting once again started after dialysis and not relieved by Pulsatilla this time. He was having head heaviness after and during each dialysis; there was a rise in BP. I told him by phone to take one dose of Arsenic alb 30c when he was suffering from high fever with restlessness, increased thirst and frequent episodes of vomiting. It helped a lot.
4 May 2016: Two more doses of Arsenic alb 30c were given in last 20 days. He came up with the following blood report – urea 102 mg/dl and S.cr. 5.54 mg/dl.
21 June 2016: He came up with the following blood report – urea 86.1 mg/dl and S.cr. 4.14 mg/dl. He took Arsenic 30c every time he had vomiting and got relief.
24 June 2016: He went to dialysis for last time. He had started gaining weight without oedema.
11 August 2016: His blood reports were getting better despite leaving the dialysis. This time his blood reports were – urea 94 mg/dl and S.cr. 3.7 mg/dl.
7 Sep. 2016: Echocardiography reports revealed no improvement in Left ventricle EF – now it was 38%. Blood reports were – urea 74 mg/dl and S.cr. 3.1 mg/dl.
4 Oct. 2016: Normal ultra-sonography report.
5 Oct. 2016: he had noticed some reduction in urine output despite having thirst for large quantities of cold water; little swelling over face and extremities also. A little breathlessness while ascending stairs; perspiration increased more at night. He asked whether ever he could get rid of this disease. Arsenic did not work anymore. Calcaria carb 30c one dose was given.
6 Nov. 2016: He came with the following blood report – urea 94 mg/dl and S.cr. 3.0 mg/dl. He was better all the way except gaining weight and mild breathlessness on exertion. Cardiologist compelled him to continue taking Tab. Dytor (diuretic) and said he should go to some higher center for pacemaker implantation.
12 Jan. 2017: Better except gaining weight; he could not go for Pacemaker due to financial problems, so he remained under my treatment and he had been managed well by Pulsatilla 30c. In between I used Digitalis 30c (low and weak pulse rate and thirstlessness) with good response and when it failed I used Apis 30c without good response. Ultimately, I had to keep him on Pulsatilla 30c only for the feeling suffocation in closed room.
18 May 2018: Finally, he could go for checkup in AIIMS Delhi and they admitted him for the following diseases Type 2 Diabetes, HTN, coronary artery disease (CAD), cardiomyopathy with severe LV dysfunction (EF 25-30), and CKD stage 4. After a thorough checkup, they found there was no kidney issue as such at that time (S.cr was 2.2), so cardiologist gave a date for pacemaker implantation.
27 Jul.2018: He still cannot arrange money for pacemaker, so he is under my treatment as usual.
Results: Despite taking some nephrotoxic modern drugs there is no fluid collection in his body, urea and creatinine have come down to almost a normal level gradually, ultra-sonography reveals normal kidneys; all other kidney functions tests are now within normal range.
Discussion: Though he has recovered from chronic renal failure yet diabetes and cardio-myopathy are still active there. His blood sugar has started shooting up and there was no change in his symptoms related to severe LV dysfunction, so he had been referred to higher centers.Though I have been treating patients having such advance pathology in most vital organs1 so I keep such cases under close observation of a relevant conventional doctor so he was also under observation of a cardiologist and a nephrologist.Though he was an insulin dependent diabetic, yet he can manage his high blood sugar level with less insulin.Feeling suffocation in bed especially at night was his persistent symptom which is associated with renal as well cardiac pathology. Though Pulsatilla is still effective for suffocation yet I also recommended for pacemaker implantation because I cannot keep him in risk of sudden cardiac arrest due to low EF and permanent damage to aortic, mitral and tricuspid valves.
Reference:1 K K Goyal. Two cases of pulmonary TB treated with homeopathy. Homeopathy (2002) 91, 43-46