Mutrasangrahaneeya Mahakashaya with Respect to Mutrasangrahaneeya Karma in Childhood Nephrotic Syndrome: A Literary Review

Abstract Primary nephrotic syndrome (PNS) accounts for up to 20% of end-stage renal disease and 12% of chronic kidney disease, affecting 2–7 out of every 100,000 children. It is an immune-related disorder characterized by heavy proteinuria (>40 mg/m²/h), hypoalbuminemia, hyperlipidemia, and facial edema. PNS often requires corticosteroid treatment for achieving remission, and many patients may either experience a relapse or develop resistance or dependence on steroids. Minimal change nephrotic syndrome, the most common form in children, presents with normal kidney histology under a microscope, and treatment response to steroids largely influences prognosis. Steroid-resistant or -dependent individuals often experience adverse effects and variable outcomes with current protocols. There is a need for more effective treatments with fewer side effects. While Ayurveda does not classify a disease exactly like nephrotic syndrome, its symptoms resemble conditions linked to Ojas aberrations and metabolic imbalances. Ayurvedic management focuses on restoring digestive fire ( Dhatwagnimandhya ) through Amapachana , enhancing immunity ( Ojovardhana ), rejuvenation ( Rasayana ), and correcting fat metabolism ( Medovaha Srotodusti ). Ayurvedic diuretics ( Mutrala ) and renal protective therapies are also recommended for holistic care, suggesting an integrative approach may offer potential benefits alongside conventional treatment. The Mutra Sangrahaneeya Mahakashaya drugs which includes Jambu, Aamra, Plaksha, Vata, Kapeetana, Udumbara, Ashvattha, Bhallataka, Ashmantaka, and Somavalka , which have also been mentioned in different conditions of Shotha in Ayurveda classics, have a significant role in controlling the glomerular filtration rate, hence reducing protein loss and decreasing proteinuria, edema, and the whole sequence of nephrotic syndrome.