A Randomised Prospective clinical study to evaluate the effect of sinhasyadi vati with standard treatment protocol of ckd in management of vatbasti mutraghat with respect to chronic kidney disease stage 2

chronic kidney disease  is a syndrome characterized by progressive and irreversible deterioration of renal function due to slow destruction of renal parenchymal eventually terminating in death when sufficient numbers of nephrons have been damaged over a period of months or years. It is also called as chronic renal failure  It is an internationally recognized public health problem affecting 5 10percent of world population generally signs and symptoms of renal disease are often non-specific the signs and symptoms may appear at the stage of irreversible damage which include nausea vomiting anorexia sleep problems changes in urine output decreased mental sharpness muscle twitches cramps hiccups anasarca persistent itching shortness of breath fatigue and weakness etc often it is diagnosed as a result of high blood pressure or diabetes and those with a blood relative with renal disorders It is considered as long term form of kidney disease and is differentiated from acute kidney disease in that the reduction in kidney function must be present for over 3 months2

according to ayurveda it can be correlated with Mutraghata belonging to pathology of mutravaha srotasa. mutraghata is one of the most common and distressing disease among the group of urinary disorder.For easy to understand the 12 types of Mutraghata are being classified into three categories The first category is based on the neurogenic disturbances of the bladder and the types that can be included under this are  Vatakundalika Vatabasti and Mutrajathara The second category with the symptomatology of obstructed flow of urine increased frequency of urination sense of incomplete voiding etc includes Bastikundalika Mutragranthi Mutrotsarga and Ashteela types. The third category is termed as Others where the types included are Mutrakshaya Anuria Ushnavata Hematuria Mutroukasada Abnormal colorization of urine Vidvighata faecum passed per uretherum and Mutrashukra Retrograde flow of semen Mutraghata is a condition in consequence with some kind of Obstructive Uropathy either mechanical or functional related either to upper or lower urinary tract resulting in to either partial or complete retention of urine as well as Oliguria or Anuria Normal functions of Mutravaha srotasa urinary system is regulated by Apana vayu one among the five types of Vayu.Any derangement in Apana vayu leads to the pathology of the urinary system. So the treatment principle is to correct the vitiated Apana Vayu thereby attaining the normal physiology of the urinary system. This controls the symptoms of the Mutravaha Srotasa. Acharya Charaka has mentioned eight types in Sutrasthana Further, in Siddhisthana thirteen types of Basti rogas have been described under the heading of Mutradosha. Acharya Sushruta has explained twelve types of Mutraghata in Uttaratantra but in spite of Bastikundalika and Vidvighata varieties as described in Charaka. Sushruta has described the two type of Mutroukasada i.e Pittaja and Kaphaja while Charaka and Vagbhata described only one type i.e. Mutroukasada6. Ashtanga Sangraha and Ashtanga Hridaya, includes Mutrakricchra and Ashmari rogas. Acharya Vagbhata has categorized the diseases of Mutravaha Srotasa into two types i.e. Mutra Atipravrittijanya and Mutra Apravrittijanya Rogas. Mutra vegavarodha is mentioned as one of the most important causative factor in Mutraghata. It is but clear that the Apana vayu is responsible for normal voiding of urine, if deranged by voluntary suppression of urge of micturition which results in Mutraghata