Managing Uremia: Can Traditional Chinese Medicine Help?

Uremia

Hello, my mother has recently been experiencing vomiting and loss of appetite.
After going to the hospital for examination, she was diagnosed with uremia, and the doctor recommended dialysis.
However, my mother is reluctant to accept dialysis due to her conservative beliefs.
She has some facial edema and decreased urine output.
Can traditional Chinese medicine effectively improve these symptoms? Currently, she is taking Jisheng Shenqi Wan, Bai Mao Gen, Hai Piao Xiao, Pi Xie, and Dan Shen.
What are your thoughts on this? She is also continuing to take Western medicine.
My mother has high blood pressure and diabetes, but her blood sugar is well controlled, around 110 before meals.
How should she maintain her health? Thank you.

Pipi, 40~49 year old female. Ask Date: 2008/04/20

Dr. Lin Qingzhong reply Traditional Chinese Medicine

Dear Pi Pi/1/41 user,
1.
Your mother has recently been experiencing vomiting and loss of appetite, and after being examined at the hospital, she has been diagnosed with uremia.
The doctor has recommended dialysis.
You and your family, including friends, must find a way to persuade your mother to promptly accept the doctor's advice and go to the hospital for dialysis arrangements.
If uremia is not treated with dialysis, her blood urea nitrogen (BUN), creatinine (Cr), and potassium (K) levels may rise too high, leading to a stage where dialysis is necessary.
High levels of these toxins can harm the entire body, including the brain and heart, causing electrolyte imbalances, acid-base disturbances, edema, vomiting, loss of appetite, and even coma or cardiac arrest, which can be life-threatening or even fatal.
2.
Your mother may be suffering from chronic kidney disease due to hypertension, diabetes, and other long-term conditions, which may have progressed to end-stage renal disease (ESRD).
At this point, no medication, whether traditional or Western, can reverse the decline in kidney function.
The only option to preserve her life is to undergo dialysis as soon as possible.
3.
It is recommended that you urgently encourage your mother to see a nephrologist for dialysis and related measures.
4.
If the hospital confirms the diagnosis of uremia and the doctor advises dialysis, she must bravely accept the treatment to preserve her life.
5.
In cases of chronic kidney disease where BUN, Cr, and K levels are slightly elevated, traditional Chinese medicine may help alleviate the rapid deterioration of the condition, and treatment can be adjusted based on symptoms.
However, since your mother has reached the uremic stage (CCR < 5), with renal failure, no medication can alter the course of her uremic condition.
Do not hesitate; she must undergo dialysis immediately, as this is the only correct medical approach to save her life.
Wishing you all the best,
Dr.
Lin Ching-Chung, Assistant Professor, Director of Traditional Chinese Medicine Department, Fengyuan Hospital

Reply Date: 2008/04/20

More Info

Managing uremia, particularly in patients who are hesitant to undergo dialysis, can be a complex challenge. Uremia is a condition that arises when the kidneys are unable to filter waste products from the blood effectively, leading to a buildup of toxins. This condition can manifest with symptoms such as nausea, vomiting, loss of appetite, and fluid retention, as seen in your mother’s case. Given her reluctance to pursue dialysis, exploring complementary approaches, including Traditional Chinese Medicine (TCM), may provide some benefits, although it is essential to approach this with caution and under professional guidance.

TCM offers a holistic perspective on health, focusing on restoring balance within the body. It employs various modalities, including herbal medicine, acupuncture, dietary therapy, and lifestyle modifications. The herbs your mother is currently taking, such as Jisheng Shenqi Wan (濟生腎氣丸), Bai Mao Gen (白茅根), Hai Piao Xiao (海嫖蛸), Bi Xie (萆薢), and Dan Shen (丹參), are commonly used in TCM to support kidney function and alleviate symptoms associated with uremia.
1. Jisheng Shenqi Wan is traditionally used to tonify kidney qi and nourish yin, which may help improve energy levels and overall vitality.
2. Bai Mao Gen is known for its diuretic properties and can help reduce fluid retention, which is beneficial for your mother’s swelling.

3. Hai Piao Xiao is often used for its ability to stop bleeding and promote healing, which may be advantageous in managing any complications related to uremia.

4. Bi Xie is recognized for its ability to promote urination and clear dampness, potentially aiding in fluid management.

5. Dan Shen is valued for its ability to improve blood circulation and may help mitigate some of the cardiovascular risks associated with kidney disease.

While these herbs can provide symptomatic relief and support kidney health, it is crucial to understand that they are not a substitute for conventional treatments, especially in cases of severe uremia. The effectiveness of TCM in managing uremia is still a subject of research, and while some studies suggest positive outcomes, more rigorous clinical trials are needed to establish definitive benefits.

In addition to herbal therapy, acupuncture may also be beneficial. It can help alleviate symptoms such as nausea and improve overall well-being. However, it is essential to seek treatment from a qualified practitioner who understands the complexities of kidney disease.

Regarding your mother’s existing conditions—hypertension and diabetes—it's vital to maintain regular monitoring and management of these diseases. A well-balanced diet low in sodium and protein may help reduce the workload on her kidneys. Encouraging her to stay hydrated, within the limits advised by her healthcare provider, is also important.
It is advisable to continue her prescribed Western medications while integrating TCM. Open communication between her TCM practitioner and her primary healthcare provider is essential to ensure that all treatments are coordinated and that there are no contraindications.

In summary, while TCM may offer supportive care for managing uremia, it should be viewed as a complementary approach rather than a standalone treatment. Regular follow-ups with her healthcare team are crucial to monitor her kidney function and overall health status. If her condition worsens or if she experiences significant symptoms, it may be necessary to reconsider the option of dialysis or other medical interventions.

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