CRUCIAL ROLE OF SERUM CYSTATIN-C AS A MARKER FOR EARLY DETECTION OF RENAL DYSFUNCTION IN DIABETES MELLITUS WITH SPECIAL REFERENCE TO PRAMEHA IN AYURVEDA

Abstract

Diabetes mellitus is a chronic disease characterized by derangements in carbohydrate, fat and protein metabolism. It is a clinical condition characterized by increased blood glucose level (hyperglycemia) due to insufcient or inefcient insulin. It is a most common metabolic disorder in India. Diabetic nephropathy is currently one of the leading causes of morbidity and mortality in diabetic population, accounting for greatest proportion of end stage renal disease worldwide. In Ayurveda Prameha is usually correlated with Diabetes Mellitus with important symptoms like Prabhoota Mutrata i.e Increased frequency and quantity of urine and Avila Mutrata which means turbid urine. Prameha is considered as Chirakaaleena vyadhi(chronic disease) which is Anushangi1(recurring) in nature. It is due to vitiation of tridoshas (vata-pitta-kapha) especially Kapha dosha which can be considered as important components of protoplasm2 which governs all the activities of body and also symbolizes the physico-biological properties of compounds made through a different combination of Panchamahabhootas i.e Akasha(space), Vayu(electrons), Teja(energy), Jala(proton) and Prithvi(neutron)3.GFR (Glomerular ltration rate) is considered as the best indicator of overall kidney function and therefore its assessment has become an important clinical tool in daily patient care. A stepwise increase in nitrogenous constituents of blood like urea, creatinine etc and other biochemical parameters like albumin, electrolytes etc also believed to reect deteriorating kidney function. Cystatin-c4 is one among Renal Function Tests. It is done to detect chronic kidney dysfunctions. It is considered as better marker for GFR than Serum Creatinine. Even in disease Prameha(DM) Renal functions predominantly gets disturbed leading to many future complications. So the pivotal role of serum Cystatin-C as a marker for early detection of renal dysfunction in Diabetes Mellitus will be discussed elaborately which may be benecial in decreasing the incidence of patients landing up in complications especially related to renal system.