An Introduction to the Excretory System
The excretory system includes a pair of kidneys, ureter, urinary bladder and urethra. The parts of the excretory system have been shown in following diagram.
Fig: Anatomy of human excretory system
Brief description of the parts of the excretory system is discussed below:
- Kidneys. The kidneys, two in number, are situated in the back part of the abdomen, and are for the purpose of separating from the blood certain materials which, when dissolved in a quantity of water, also separated from the blood by the kidneys, constitute the urine. The right kidney is usually on a slightly lower level than the left.
The kidney is surrounded by a distinct layer of fibrous tissue which forms a smooth but firm covering around the organ. Each kidney is bean shaped and divided into cortex and medulla. It is made of uriniferous tubules which are interwoven with blood capillaries and held together by connective tissue. Microscopically kidney is made of numerous nephrons. They are structural and functional unit of the kidneys. Kidneys have a rich blood supply.
- Ureters. The ureters are two tubes which conduct the urine from the kidneys into the urinary bladder.
- Urinary bladdar: The urinary bladder is a reservoir of urine.
The kidneys maintain the chemical composition of the body fluids. They not only remove the metabolic wastes, but also eliminate nitrogenous wastes, excess of water, salts and other excess substances. The kidneys play significant role in short and long term management of hypertension.
Physiology of human excretory system
Man passes about 1.5 liters of urine in 24 hours. Urine is a yellowish fluid, it shade depends on its concentration. It mainly contains water and organic and inorganic substances. Inorganic salts include chlorides, sulphates, and phosphates of sodium and potassium. Organic substances include urates, uric acid and creatinine.
Urine is produced and drained continuously by the urinary tubules into the kidney. From here it enters into the urinary bladder. Sphincters prevent the back flow of urine. As the urine collects, the muscular walls of the bladder distend. Reflexes come into action and there is an urge to discharge the urine.
Some common diseases of the urinary system are Vasti-shotha (cystitis), painful micturition or Mutra-krricha (Dysuria), blood in urine or Rakta meha (haematuria), Gurdae ki pathari or kidney stone or Ashmari (Renal calculi), excess urination or Prameha (Polyuria).
Urinary Calculus Incidence in India compared to worldwide
These dietary changes have also been reported in many other countries, including China, India, Egypt, Russia, and the Philippines. High fructose consumption has been demonstrated to be a risk factor for stone formation.
In the United States, overall stone prevalence has doubled since the 1964–1972 time period, and appears to have stabilized since the early 1980s.
Other countries with documented increases in prevalence include Germany, Spain, and Italy. Regional reports from Milan, Italy, also document an increased prevalence. Only Scotland had a slight decrease in prevalence from 3.83% in 1977 to 3.5% in 1987.
A kidney stone is a common problem. It affects 10 per cent of men and 3 per cent of women. The stones are made of calcium, oxalate, phosphate, urate and uric acid. Rarely stone is formed of calcium, magnesium and ammonium (combination), cystine, xanthine or indicine.
Signs and symptoms
Chief complaint of kidney stone is a pain which appears suddenly, starts from the back and radiates to the thighs. Nausea and vomiting are sometimes encountered. Some patients may complain about severe constipation. Stone can be formed in the ureter and bladder also. Here the pain may radiate from the thighs to sex organs.
Haematuria (blood in the urine) is the main feature of kidney stone. Urine examination in the laboratory test reveals the presence of red blood corpuscles. Calcium and oxalate stones are mainly found in clinical practice. Patients having a history of gout may go on to develop urate stones.
Haematuria refers to the presence of red blood corpuscles in the urine. It can be caused by a number of factors like a stone in the kidney or urinary bladder, inflammation of the urinary bladder (cystitis), injury to the kidney. When a person with a history of kidney stone tries to void urine, the stone may scratch the organ resulting in haematuria.
Surgery in the form of lithotripsy is the only solution in case of kidney stones. However, it has not permanent; cure and chances of stone formation remain high.
- Powder of Varuna (Crataeva nurvala) in a dose of one teaspoonful (5g), with water, is recommended thrice a day for fourteen days. It helps in expelling the stone, by breaking into small particles.
- Pasanabheda is another drug worth consideration, Ayurvedic name of the drug means to crush the stone. One teaspoonful (5g), of the powder of the drug, thrice a day, is good for renal calculi patients.
- Yava-kshara or potassium bicarbonate (it is prepared by burning of Apamarga or poothkanda) acts as a renal alkalinizer but expels the crushed particles of the stones. The dose of Yava-ksahara should be prepared by an expert Ayurvedic Physician.
- Alternatively, decoction of poonarnava in a dose of three teaspoonfuls (15 ml) is good diuretic.
- If there is a urinary obstruction due to kidney stone, Gokshuradi-guggul, one tablet is given with Gokshura-quatha six teaspoonfuls (30 ml) twice a day.
Ayurveda Clinical Studies
- A comparative study was conducted on 20 patients. 10 patients of Group I received Yava Kshara and remaining 10 patients were given an indigenous drug called GCP Compound for a period of 60 days. Statistical analysis showed that P – value of less than 0.05 was seen in Group I from 0 to 60 days course. There was no significant difference observed in the stone size in Group I when the actual value and calculated value were compared.
- Sveta parpati with Kulatha kwatha in highly effective in urolithiasis.
- Varuna (Crataeva nurvala) has good role as anti-utolithic agent.
- Pashanbheda (Bergenialigulata) is reputed Ayurvedic remedy for curing and preventive kidney stones.
- In experimental studies, Hajrul Yahud Bhasma has been found to be effective.
Precautions and diet:
- Less intake of water contributes to the incidence of kidney stones. Eight to ten glasses of water daily are helpful to flush out the stones from the kidneys.
- Oxalates rich foods such as spinach, cauliflower, strawberries should be avoided. Chocolates, tea and beets are also rich in oxalates.
- Coriander, radish and ladyfinger are good for kidney patients as they are natural diuretics.
- Kumar A, Kumar N. To evaluate the effect of Ayurvedic drugs (a herbomineral combination of Sveta parpati with Kulatha kwatha) in the management of mutrasmari (urolithiasis). J. Res Ayur Siddha 1995; 16:35-42.
- Varalakshmi P, Shamila Y, Latha E. Effect of Crataeva nurvala in experimental urolithiasis. J Ethnopharmacol 1990; 28(3): 313-21.
- Bahl CP, Seshadri tr. Eds.1978.Pashanbhed: drugs for urinary calculus, K.N. Udupa 77-98.
- Romero V, Akpinar H, Assimos DG. Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors. Rev Urol 2010 Spring-Summer; 12(2-3): e86–e96.
- Chakradhar KV, Datatreya RS. To Evaluate the Potential of Yava Paneya Kshara (Alkali Preparation of Barley) on Nephrolithiasis – A Pilot Study. Int Ayur Med J 2013; 1:30-6.
- Rao N, Shah J, Patel K, Gandhi TE. Evaluation of the efficacy of Hajrul Yahud Bhasma in urolithiasis using rat as an experimental model. Ind J Pharmacol 2011;
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