therapy spotlight Integrative Approaches
to Kidney Dysfunction by Maoyi Cai
W
estern physicians are sometimes confused by a Traditional Chi- nese 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. Te 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 medi- cine is necessary. TCM considers the kidneys to be the congenital foundation of the body, which govern the birth, growth, develop- ment and reproduction. Te kidneys store the essence, control the bones, produce the marrow to fill the brain, regulate water metabo- lism, 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 medi- cine 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. Tey filter extra water and wastes out of blood to form urine, thereby maintaining normal body fluids, electrolytes and acid/base balance. Te kidneys also activate vita- min D to keep the bones healthy and secrete a hormone (erythro- poietin) to stimulate the bone marrow to produce red blood cells. Chronic kidney disease occurs when the kidneys are dam-
aged slowly over many years. Tis is oſten due to diabetes mellitus, hypertension or other diseases, and the resulting condition is known as nephropathy. Te 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. Te 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 deficien- cy, 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, M.D., DiplOM (NCCAOM), is the academic dean and bio- medical director at Texas Health and Science University. See ad, page 15.
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