The current scenario suggested a sudden spike in the number of CKD suffers. With no suitable treatment, the condition intimidates high-end physical, mental & financial burdens on family & co-supporters. The rising cases no longer look to slow down, associated diabetes or Diabetes kidney diseases (DKD) can be a massive load over the entire system. Turing, the tire with recently advanced treatment, is in need of an hour.

DKD can be defined by elevated urine albumin excretion or reduced glomerular filtration rate (GFR) in patients with diabetes. With the increase in the prevalence of diabetes, the burden of chronic kidney disease (CKD) is parallelly increasing. The CKD registry claims more than 31% of people with kidney disease and diabetes in India. According to a 2015 report titled "Start India Project," more than 40% of type 2 diabetes mellitus patients have CKD, whereas only one CKD patient out of every five hypertensive subjects has CKD. Epidemiological studies predict this prevalence is expected to rise in the future even faster. A recent study concludes that despite the advancements, current therapy can not completely halt the progression of DKD, and DKD remains the leading cause of end-stage kidney disease (ESKD) or kidney failure worldwide.

DKD: A silent progressor

In diabetes, high blood sugar affects the kidneys’ ability to remove waste products and extra fluid from the body. In the initial phase of DKD, a slow and gradual decline in renal function remains unnoticed, and consequently, 90% of patients do not experience any signs and symptoms. The gradual decline in the functions of the kidney progress silently towards renal failure or ESKD, making it challenging to preserve residual renal functions. In the late stage of CKD, it is tough to manage kidney health, and most intervention aims to improve the health-related quality of life of patients with kidney disease. Therefore, guidelines recommend intervention therapeutically as early as possible to delay disease development. Duration of diabetes mellitus and other associated comorbidities or risk factors can help predict the kidneys' health and accordingly choose the appropriate therapeutic approach to manage DKD.

DKD: The missing link/unmet need

Recent advances in medicine and technology have helped patients with DKD better control their blood sugar and blood pressure levels, leading to a significant reduction in amputations and heart-disease complications. Unfortunately, all currently available therapies aim to slow the disease progression and there are no therapies to stop or reverse the damage to the kidneys' filtering system. Therefore, the therapeutic interventions/approach to preserve renal functions can be considered helpful in improving the kidney's functional capacity.
 
DKD: Finding the root cause to meet the unmet need

Several underlying pathophysiological mechanisms like oxidative stress, inflammation, apoptosis, etc., individually or collectively contribute to the progression of DKD. It is important to target all the possible causes to alleviate the progression. The occurrence of serious adverse events has hampered the increasing use of western medicine during the management or treatment of kidney disease. On the other side, traditional medicines deal with various phytoconstituents that play an essential role in disease treatment due to their synergistic potential. Herbal medicine is becoming more popular as an alternative treatment in developed and developing countries due to its natural origin, low or no side effects, affordability, and accessibility. Notably, herbal medicines are reported to preserve renal functions by preventing tubular damage in the nephrons. In cases where dialysis or kidney transplant are the only options for patients, herbal medicine may be an effective treatment option by improving biochemical markers, glomerulosclerosis, and GFR.

Turn the tide of DKD: Management by natural approach

Herein, some essential herbs are listed that are beneficial in maintaining and managing kidney disease:

Boerhavia diffusa: Restores antioxidant defense, the functional capacity of kidney and hasten recovery from glomerulonephritis, tubular cell toxicity, and altered intraglomerular hemodynamics with a reduction in inflammatory and oxidative responses.

Cichorium intybus: Reconditions the function of glomerular, peritubular, blood vessel congestion with the presence of inflammatory cells causing severe necrosis.

Nelumbo nucifera: Enhances speedy restoration of nephron functions via antioxidative action.

Butea monosperma; Preserve podocyte and tubulointerstitial inflammation via antioxidative action, normalize biochemical and histopathology altered due to oxidative stress.

Tribulus terrestris: Improve renal epithelial damage, inflammation, and glomerular morphology and reduce biochemical biomarkers urea and creatinine levels to normal and reduce onslaughts of oxidative stress.

Coriandrum sativum L.: Preserve the absorption function distorted due to damaged glomerular and tubular parts of the kidney.

Hemidesmus indicus L.: Restore the function of renal tubule against glomerulonephritis, antioxidant defense system, and altered intraglomerular hemodynamics.

Moringa oleifera L.: Ameliorates urinary excretion of electrolytes or plasmatic levels of Na+ and K+ ions.
 
On-time supplementation of the right combination of herbs can surely be a boon for patients suffering from DKD. Available research suggests that herbal medicines can help improve the functional capacity of kidneys and preserve renal functions. To extend the benefit Aimil Pharmaceuticals (India) Limited has come up with NEERI KFT, which combines all the herbs mentioned above and other reno-protective herbs in their best quality, helping sufferers to delay the episodes of dialysis & kidney transplant.