Ayurvedic Management of Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is one of the fastest-growing non-communicable disease burdens globally, with prevalence in European adult populations now above 10%. Conventional management is reasonably effective at slowing progression (ACE inhibitors and angiotensin receptor blockers, blood pressure and glycaemic control, SGLT2 inhibitors in recent years), but patients still progress to end-stage kidney disease at substantial rates. Ayurvedic medicine has engaged with kidney disease under the classical categories of Vrukka Roga and Mutravaha Srotas Dushti for centuries, with a repertoire that includes well-characterised nephroprotective herbs (Punarnava, Gokshura, Varuna), classical polyherbal formulations (Punarnavadi Mandur, Gokshuradi Guggulu, Chandraprabha Vati), and structured dietary and lifestyle interventions. This study is a structured clinical review of 58 primary preclinical, clinical and observational studies published between 2005 and 2021 evaluating Ayurvedic interventions in CKD, grouped under five approach frames: K1 (single-herb nephroprotection), K2 (classical polyherbal formulations), K3 (integrated protocols combining herbs, diet and lifestyle), K4 (diabetic nephropathy-specific protocols), and K5 (adjunctive therapy in advanced CKD and dialysis support). Each frame was scored with the Kidney Clinical Index (KCI), a weighted composite across eGFR trajectory, proteinuria reduction, safety in the renal population, quality of life, and progression delay. Integrated protocols (K3) and diabetic nephropathy-specific regimens (K4) scored highest (KCI 0.838 and 0.822), with safety as the dominant scoring driver across all frames.