Comprehensive Ayurvedic Approach to Mutravaha Srotas Dushti in Chronic Kidney Disease: Clinical Evidence from a Case Study
DOI:
https://doi.org/10.48165/prakriti.2025.2.01.18Keywords:
Mutravaha Srotas Dushti, Nidana Parivarjan, Panchakarma, Rasayana, Shamana Chikitsa, Shodhana Chikitsa and Vrikk RogAbstract
Chronic Kidney Disease (CKD), a progressive and irreversible decline in renal function, is a growing global health concern. Ayurveda correlates CKD with Mutravaha Srotas Dushti, wherein vitiated Vata and Kapha, along with Rakta and Meda dushya, contribute to Srotorodha (obstruction), degeneration, and functional impairment of the kidneys. This case study presents a 59-year-old male with CKD, managed through an integrative Ayurvedic protocol. The treatment strategy emphasised Nidan Parivarjan (elimination of causative factors), personalised Ahar (renal-specific diet), Vihar (lifestyle regulation), Shodhana (detoxification), and Shamana (palliative therapy). Panchakarma interventions were administered alongside classical formulations. Key therapeutic herbs—Punarnava (Boerhavia diffusa) and Gokshur (Tribulus terrestris)—demonstrated diuretic, anti-inflammatory, and Rasayana properties, improving renal clearance and reducing oedema. The patient exhibited significant clinical and biochemical improvement, highlighting Ayurveda’s potential in nephroprotection and holistic CKD management.
References
Kalantar-Zadeh, K., Jafar, T. H., Nitsch, D., Neuen, B. L., & Perkovic, V. (2021). Chronic kidney disease. The Lancet, 398(10302), 786–802.
Levey, A. S., & Coresh, J. (2012). Chronic kidney disease. The Lancet, 379(9811), 165–180.
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. The Lancet, 389(10075), 1238–1252.
Romagnani, P., Remuzzi, G., Glassock, R., Levin, A., Jager, K. J., Tonelli, M., ... & Anders, H. J. (2017). Chronic kidney disease. Nature Reviews Disease Primers, 3(1), 1–24.
Ammirati, A. L. (2020). Chronic kidney disease. Revista da Associação Médica Brasileira, 66, S03–S09.
Charles, C., & Ferris, A. H. (2020). Chronic kidney disease. Primary Care, 47(4), 585–595.
Drawz, P., & Rahman, M. (2015). Chronic kidney disease. Annals of Internal Medicine, 162(11), ITC1–ITC16.
Levin, A., Hemmelgarn, B., Culleton, B., Tobe, S., McFarlane, P., Ruzicka, M., ... & Tonelli, M. (2008). Guidelines for the management of chronic kidney disease. CMAJ, 179(11), 1154–1162.
El Nahas, A. M., & Bello, A. K. (2005). Chronic kidney disease: The global challenge. The Lancet, 365(9456), 331–340.
Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., ... & Yang, C. W. (2013). Chronic kidney disease: Global dimension and perspectives. The Lancet, 382(9888), 260–272.
Soliman, A. R., Elkhatib, M., El-Khashab, S., Darwish, R. A., Fayed, A., Abdelaziz, T. S., Hammad, H., Ahmed, R. M., & Maamoun, H. A. (2025). Dual-faced guardians: SGLT2 inhibitors' kidney protection and health challenges: A position statement by Kasralainy Nephrology Group (KANG). Diabetology & Metabolic Syndrome, 17(1), 214. https://doi.org/10.1186/s13098-025-01790-w
Bakris, G. L., Agarwal, R., Anker, S. D., Pitt, B., Ruilope, L. M., Rossing, P., Kolkhof, P., Nowack, C., Schloemer, P., Joseph, A., Filippatos, G., & FIDELIO-DKD Investigators. (2020). Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. The New England Journal of Medicine, 383(23), 2219–2229. https://doi.org/10.1056/NEJMoa2025845
Perkovic, V., Barratt, J., Rovin, B., Kashihara, N., Maes, B., Zhang, H., Trimarchi, H., Kollins, D., Papachristofi, O., Jacinto-Sanders, S., Merkel, T., Guerard, N., Renfurm, R., Hach, T., Rizk, D. V., & APPLAUSE-IgAN Investigators. (2025). Alternative complement pathway inhibition with iptacopan in IgA nephropathy. The New England Journal of Medicine, 392(6), 531–543. https://doi.org/10.1056/NEJMoa2410316
Delrue, C., Eisenga, M. F., Delanghe, J. R., & Speeckaert, M. M. (2024). Personalized antifibrotic therapy in CKD progression. Journal of Personalized Medicine, 14(12), 1141. https://doi.org/10.3390/jpm14121141
Kawai, T., Williams, W. W., Elias, N., Fishman, J. A., Crisalli, K., Longchamp, A., ... & Riella, L. V. (2025). Xenotransplantation of a porcine kidney for end-stage kidney disease. The New England Journal of Medicine, 392(19), 1933–1940.
Yang, L., & Li, Y. (2024). Wearable artificial kidneys: The first choice for portable renal replacement therapy. Integrative Medicine in Nephrology and Andrology, 11(2), e24-00007. https://doi.org/10.1097/IMNA-D-24-00007
Tabibzadeh, N., & Morizane, R. (2024). Advancements in therapeutic development: Kidney organoids and organs on a chip. Kidney International, 105(4), 702–708. https://doi.org/10.1016/j.kint.2023.11.035
Alobaidi, S. (2025). Emerging biomarkers and advanced diagnostics in chronic kidney disease: Early detection through multi-omics and AI. Diagnostics, 15(10), 1225. https://doi.org/10.3390/diagnostics15101225
Chate, S. B., & Ranade, A. (2024). Ayurvedic pathogenesis of chronic kidney disease: A critical review. International Journal of Creative Research Thoughts, 12(11). https://www.ijcrt.org/issn.php?uid=2320-2882
Tiwari, H., Dang, P., Badyal, S., & Dhawan, P. (2024). Chronic kidney disease (CKD) pathogenesis in Ayurveda parlance: A review. International Ayurvedic Medical Journal, 8, 138–145. https://doi.org/10.46607/iamj06p8022024
Kapoor, A. B., & Dang, P. G. (2020). Role of Ayurveda in the management of chronic kidney disease: A case study. Journal of Ayurveda Case Reports, 3(1), 14–19.
Rachana, M. S., Totad, M., Girish, K. J., & Vasantha, B. (2019). Ayurvedic management of chronic kidney disease: A case report. Journal of Ayurveda and Integrated Medical Sciences, 4(6), 285–290.
Aggarwal, A., Sokiya, G., & Sharma, G. (2023). Management of chronic kidney disease: An Ayurveda case study. Journal of Ayurveda and Integrated Medical Sciences, 8(7), 250–256.
Ghaywate, R. B. (2020). Role of Ayurveda in chronic kidney disease: A case study. World Journal of Pharmaceutical Research, 9, 11302277–67105.
Farncombe, M. (1997). Dyspnea: Assessment and treatment. Supportive Care in Cancer, 5(2), 94–99.
Brodovicz, K. G., McNaughton, K., Uemura, N., Meininger, G., Girman, C. J., & Steven, H. (2009). Reliability and feasibility of methods to quantitatively assess peripheral edema. Clinical Medicine & Research, 7(1–2), 21–31. https://doi.org/10.3121/cmr.2009.825
Breivik, H., Borchgrevink, P. C., Allen, S. M., Rosseland, L. A., Romundstad, L., Breivik Hals, E. K., Kvarstein, G., & Stubhaug, A. (2008). Assessment of pain. BJA: British Journal of Anaesthesia, 101(1), 17–24. https://doi.org/10.1093/bja/aen103
Dukare, P., Gandhi, S., Shinde, S. T., & Patil, R. (2024). Matra basti: A review.
Singh, V. P. K., & Verma, M. (n.d.). Importance of Panchakarma WSR basti procedure & mode of action.
Bairagi Bhushan, A., Gadkari Parag, U., & More Manjusha, S. (n.d.). Clinical evaluation of Varunadi Taila Vrikkabasti in the management of renal calculi.
Bhusal, N., & Bhatted, S. K. (2015). Conceptual study of Shirodhara.
Nagawade, R. S. (n.d.). A review article on Avagaha Sweda. International Journal of Research Publication and Reviews.
Acharya, M., Chaudhary, G., Singh, S. P., Singh, M., & Richa, D. (2024). Clinical evaluation of chronic kidney disease management: Integrating lifestyle modification and Ayurveda. International Journal of AYUSH, 13(10), 12–25. https://doi.org/10.22159/prl.ijayush.v2013i10.1152
Garud, S., Chaudhary, A., & Kotecha, M. (2017). Pathya-Apathya: A peculiarity of Ayurveda. International Journal of Ayurvedic and Herbal Medicine, 7(4), 2635–2642. https://doi.org/10.18535/ijahm/v7i4.01
Hospital & Institute of Integrated Medical Sciences. (n.d.). What is DIP diet? How does it help cure kidney disease? HIIMS. https://hiims.in/blog/dip-diet-for-kidneys/
Suman, & Joshi, N. K. (2024). Millets: Forgotten grains with potential health benefits in Ayurveda with special reference to Kodrava. Journal of Ayurveda and Integrated Medical Sciences, 9(7), 230–236. https://doi.org/10.21760/jaims.9.7.35
Das, C., & Singh, M. P. (2023). A pharmaco-therapeutic study of Gokshur in Mutrakriccha Vyadhi WSR to UTI. International Journal of Ayurveda and Pharma Research, 17–23.
Bhowmik, D., Sampath, K. K. P., Srivastava, S., Paswan, S., & Sankar, A. (2012). Traditional Indian herb Punarnava and its medicinal importance. Journal of Pharmacognosy and Phytochemistry, 1(1), 52–58.
Parmar, D., Rathva, D., Prince Pal, D. S. U., & Upadhyay, U. (n.d.). A review on Brahmi oil.
Bhola, S., & Rao, M. P. (2016). Are Rasapanchaka physical effects or pharmacological effects? A detailed review. World Journal of Pharmaceutical Research, 404–415.
Mishra, S., Dash, R., & Kumar, S. (2024). Chronic kidney disease in light of Ayurveda: A literary review on Vataj Pandu. International Journal of Ayurveda and Pharma Research, 65–68. https://doi.org/10.47070/ijapr.v12i4.3193
Borkar, P., Yadav, V., Tiwari, R. R., & Samarth, R. M. (2022). A systematic review of potential candidates of herbal medicine in treatment of chronic kidney disease. Phytomedicine Plus, 2(4), 100361. https://doi.org/10.1016/j.phyplu.2022.100361
Patel, M., Patel, M., Patel, K., Wischnewsky, M., Stapelfeldt, E., Kessler, C. S., & Gupta, S. N. (2020). Deceleration of disease progression through Ayurvedic treatment in nondialysis stages IV–V patients with chronic renal failure: A quasi-experimental clinical pilot study with one-group pre- and postdesign and two premeasurements. Journal of Alternative and Complementary Medicine, 26(5), 384–391. https://doi.org/10.1089/acm.2019.0419
Yan, Z., Wang, G., & Shi, X. (2021). Advances in the progression and prognosis biomarkers of chronic kidney disease. Frontiers in Pharmacology, 12, 785375. https://doi.org/10.3389/fphar.2021.785375
Patankar, S., Gorde, A., Patankar, S., Raje, R., Devanpally, C., Ausekar, P., Patil, G., & Chitale, S. (2025). A prospective, randomised, open-label, parallel-group, comparative clinical trial to evaluate the safety and efficacy of combination of herbal oral capsule and rectal medication to improve gut health of type 2 diabetic patients having chronic kidney disease (CKD). Journal of Ayurveda and Integrative Medicine, 16(2), 100992. https://doi.org/10.1016/j.jaim.2024.100992
Al Khodor, S., & Shatat, I. F. (2017). Gut microbiome and kidney disease: A bidirectional relationship. Pediatric Nephrology, 32, 921–931.

