Integrative Approaches to Kidney Dysfunction
Western physicians are sometimes confused by a Traditional Chinese Medicine (TCM) diagnosis of a patient with so-called kidney deficiency, because the renal function tests ordered by the physician for the same patient have shown normal results. The question lies in how kidney deficiency in TCM is related to renal insufficiency, or failure, in Western medicine.
To answer this question, having a clear understanding of the kidney function and dysfunction in both TCM and Western medicine is necessary. TCM considers the kidneys to be the congenital foundation of the body, which govern the birth, growth, development and reproduction. The kidneys store the essence, control the bones, produce the marrow to fill the brain, regulate water metabolism, open into the ear and reflect on the hair of the head.
Kidney deficiency may involve yin, yang, qi, essence, and blood with specific clinical manifestations, and its diagnosis is based on the pattern identification or syndrome differentiation. Treatment modalities in TCM include acupuncture, herbal medicine and dietary therapy to tonify or nourish the kidneys.
In Western medicine, the kidneys are the major organ of the urinary system of the body. They filter extra water and wastes out of blood to form urine, thereby maintaining normal body fluids, electrolytes and acid/base balance. The kidneys also activate vitamin D to keep the bones healthy and secrete a hormone (erythropoietin) to stimulate the bone marrow to produce red blood cells.
Chronic kidney disease occurs when the kidneys are damaged slowly over many years. This is often due to diabetes mellitus, hypertension or other diseases, and the resulting condition is known as nephropathy.
The early stage of kidney disease (renal insufficiency) has no clinical symptoms or signs, while the advanced stage may lead to renal failure, with potential cardiovascular complications such as heart attack and stroke. The diagnosis of renal insufficiency or failure depends on the blood tests to check glomerular filtration rate and the urine test to check proteins in the urine.
Early detection of kidney disease and appropriate treatment can help delay or prevent renal failure. Treatment in Western medicine focuses on the root cause. If the kidneys fail, treatment with dialysis or a kidney transplant becomes the only choice. When comparing a patient with renal insufficiency or failure in Western medicine, they conclude one must have kidney deficiency, while in TCM, they do not conclude that a patient with kidney deficiency does or does not have renal insufficiency or failure. In TCM, the two are not mutually exclusive.
Maoyi Cai, MD, DiplOM (NCCAOM) is the academic dean and biomedical director at Texas Health and Science University.