Chinese Herbs for Treating Chronic Kidney Disease

Abstract:

Chronic Kidney Disease is a serious disease that affects millions of people, however there is currently no cure. Chinese Medicine has been used for thousands of years to treat kidney issues and can offer hope to these individuals. This essay focuses on the TCM theory and treatment of chronic kidney disease with Chinese herbs.

by Joseph Alban M.S., L.Ac

Introduction

Chronic kidney disease (CKD) is a chronic degenerative disease that cannot be successfully treated with Western Medicine. If uncontrolled, the disease may progress to a state called chronic renal failure (CRF). As many as 90,000 Americans develop CRF every year and 20 million Americans currently have CKD. This is a problem all around the world, not just in the USA. In China, rather than using Western medicine, Chinese herbs and acupuncture are a common treatment.

While in China, I trained under Dr. Wang Xiao Zhun, an internal medicine doctor at the Hunan University of Traditional Chinese medicine who is an expert in the treatment of CRF. Dr. Wang’s formulas were able to help her patients maintain healthy lives and manage the disease for years with little or no Western pharmaceutical intervention, dialysis, or kidney transplantation. This paper shares her ideas about herbal medicine.

Background to Chronic Kidney Disease

Chronic kidney disease is the progressive loss of renal function. This condition is systemic and will eventually damage virtually all of the organ systems.1 It develops slowly as the nephrons of the kidney are gradually damaged and glomerular filtration rate decreases, ultimately leading to an advanced state called chronic renal failure. Imbalances in creatinine, urea, potassium, salt and water, do not become apparent until the renal function drops below 25% of normal.

The leading causes of chronic renal failure are diabetes and hypertension.2 However, glomerulonephritis, polycystic kidney disease, obstructive uropathy, and others can also cause CRF. The manifestations are primarily disturbances in electrolyte and fluid balance, removal of wastes and toxins, erthropoitein production, and blood pressure control. 3 Clinical symptoms include polydipsia, polyuria and oliguria. Depending on the stage of decline nocturia, uremia, anorexia or poor appetite, nausea and vomit, diarrhea, weight loss, pruritus, edema, and possible neurological symptoms can also occur.1 Other complications include further contribution to hypertension and anemia from the decline in production of erythrpoietin.

Chinese Medicine Diagnosis and Patterns

CKD and CRF are complex symptom patterns with deficiency as the root cause and excess as the branch manifestation. Primarily, spleen and kidney deficiency are the root cause while blood stasis, heat toxicity, and phelgm turbidity are the branch. “ It is possible the ancient doctors could not treat CKD, because they would only tonify and not treat blood stagnation as well,” Dr. Wang once remarked. “The treatment should focus on tonifying the kidneys, moving blood stagnation, and draining toxicity, but without damaging the kidneys.”

The herbs which damage the kidneys are the herbal species which contain artistolochic acid, such as guang fang ji, ma dou ling, and guan mu tong, that are associated with severe kidney damage. 4 These herbs were part of a notorious weight loss scandal in which physicians caused many of their patients to develop kidney damage.5

An Integrated Medicine Approach

In CKD there is a strong connection between the TCM pattern and modern medical research. After the basic pattern is discovered, the goal of the prescription is to address the root and the branch, creating a balanced treatment for tonifying the deficiency and getting rid of the excess. For the primary condition of kidney deficiency use zhi bai di huang wan. If it is spleen deficiency, use shen ling bai zhu san or wu ling san.

Blood stasis, toxicity, and phlegm turbidity are the primary causes of changes in the glomerular capillary blockage, sclerosis, and ischemia. Phlegm manifestation can be treated with the addition of herbs to transform phlegm and tonify the qi, such as ban xia, bai zhu, and dang shen. Another helpful concept to treat phelgm and dampness excess is the combination of aromatic herbs with cold draining herbs to help digestion and clear excess heat toxicity simultaneously. For example, the classic formula of er miao san combines cang zhu with huang bai to clear damp heat in the lower jiao. This concept can also be applied to the combination of hou po and pu gong ying or huang lian, to open and drain dampness in the middle jiao. Phlegm may manifest on the tongue and pulse, but it may also be apparent only from the hyperlipidemia.

Chronic diseases cause qi vacuity and blood stagnation. The combination of blood movers and qi tonifiers is helpful even when there are no obvious signs of blood stasis or qi vacuity. Huang qi is helpful to further tonify qi and san qi to moisten and move the blood.

The stagnation of blood and phlegm almost always create heat toxicity, which must be drained with cold draining herbs. Da huang is very important for CKD and CRF, to clear toxicity from the fu organs, eliminate dampness, promote blood flow, and remove the blood stasis. Add it to the formula in very small doses as not to over drain and move. Traditionally, da huang is thought to “get rid of the old useless things for the new useful things.” In this case, it is the blood stasis and toxicity are old and useless. Often, da huang can be combined with fu zi, in order to warm the kidney and reduce the cold properties of the da huang.

Conclusion

CRF and CKD are serious diseases that millions of around the world face, however there is currently no cure. Chinese herbs offer hope to these individuals. The focus of the treatment should be to address both the root and the branch in order to create a balanced formula of tonifying the deficiency and getting rid of the excessive.

I would like to thank Dr. Wang Xiao Zhun for the openly sharing her knowledge and experience with me. I would also like to acknowledge Dr. Gary Peng for his help with translation.

1. McCance K, Huether S. Pathophysiology: The Biologic Basis for Disease in Adults And Children Fifth Edition
St Louis: Mosby; 2005.

2. Medline Plus. Chronic Renal Failure Page. 2007. Available at http://www.nlm.nih.gov/medlineplus/ency/article/000471.htm. Accessed on Feb. 15, 2009.

3. Goroll AH, Mulley AG. Primary Care Medicine: Office Evaluation and Management of the Adult Patient
. Philadelphia: Lippincott Williams & Wilkins; 2000.

4. Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, Third Edition
Seattle: Eastland Press, Inc; 2004.

5. Mills B, Bone K. The Essential Guide to Herbal Safety. St Louis: Elsevier Churchill Livingstone; 2005.

Joseph Alban, L.Ac. practices in New York City. He can be contacted at Joseph Alban, L.Ac. 57 West 57th Street, Suite 1109 New York, NY 10019 917.887.4946.