Patient case note : Kidney Disease and Chinese Medicine

Patient K was my first patient who wants to try Chinese medicine with kidney disease in Australia.

Dr Ellen Lee MD, CMD China , Nephrology

Patient K most likely had high blood pressure for dozens of years without being diagnosed. A few years back, she had severe headaches and went to her GP. Her blood pressure was high and she was quickly referred to a specialist. She was put on a heavy regimen of prescription drugs to lower her blood pressure. Her blood pressure has been stable but her kidney continued to worsen. She felt frustrated that although her blood pressure is somewhat under control, she did not feel her health improved at all. She continued to have sporadic headaches, joint aches and upper back pain among other health problems.

She had been seeing GP and Nephrologist regularly and taking blood test for ALMOST every week! She cried and told me that doctor said there is nothing they can do, except giving her diuretics and ARB tablets. I was shocked when I found out that she doesn’t have any knowledge regarding restrict protein intake and how important keep blood pressure.

Do we really just wait till the day for the dialysis? Can we delay the dialysis or even reverse kidney function?

Working as a Nephrologist

I was working as a nephrologist using both Western and Chinese Medicine for more than 2years in China Shanghai. Every nephrologist in my hospital (Shanghai) see 80 patients for a day, and our nephrology ward is one of the busiest and the largest department in entire China. Event though we only have few minutes to see each patient, but checking blood pressure and educate to restrict of protein intake to patient is necessary.

It is very critical to manage high blood pressure for people with kidney diseases. It is a vicious circle because damaged kidney will elevate blood pressure and high blood pressure will damage kidney over time. And because of the damage, kidney loose protein – proteinuria (protein found in urine; most of time patients found bubbly urine; is an important sign of kidney health) promotes kidney failure.

We only have 100 years history of Western medicine, and still scientist are looking for medication for kidney. Clinically we use diuretics, ARB, ACEi , CCB– which are for high blood pressure and add more symptomatic drug when the problems are built (such as calcium supplement or high UA), but there is no drugs that help maintain/protect or reverse kidney function.

I believe taking western medications are necessary and compulsory.

Some patients forget about this, or maybe they don't know. Patients take medicine irregularly, or when the symptoms seem stable, stop to intake medications.

Chinese herbs with Western medicines

I explained to her that Traditional Chinese Medicine is very effective for kidney illnesses. We often experienced reversing kidney function from CKD stage3 to stage2, rarely stage4 to stage3 (stage 1 -almost normal, stage5- needs dialysis). Our strategy is to give her herbal medicines to restore her kidney functions and maintain her blood pressure, reduce BUN/UA and proteinuria, and resolve other health issues. It will allow us to reduce her/his other medications and keep her kidney functioning for a long time.

It is very critical to manage high blood pressure for people with kidney diseases. High blood pressure will damage kidney over time, and damaged kidney will elevate blood pressure hence forming a vicious cycle. Using herbal medicine to manage high blood pressure and other health problems is very advantageous because many drugs can harm kidney. Some herbs also can damage kidney and liver function, so herbal prescription should be asked to professional Chinese medicine doctor.

Stages of Chronic Kidney Disease

With our treatment of acupuncture and herbs, Patient K began to improve. Her blood pressure stabilized with GPs care (was on ARB) and her upper back pain and joint pain relived. Fatigue and headaches are much rarer. Her renal function test in November shows eGFR improved significantly from 39 to 47(from CKD3B -to CKD3A), BUN lowered from 28 to 22. Given the dramatic turnaround in the progression of her kidney disease, dialysis is no longer a possibility.Obviously Patient K is very happy with the result, and she felt much better overall. However, sadly a successful case like her is very rare.

Although Traditional Chinese Medicine treats kidney diseases very well, most Australian do no know to seek our help. Kidney disease affects 10% of Australian population . Yet I suspect probably fewer than 1% know to get treated with Traditional Chinese Medicine.