Can Kidney Disease Patients Safely Consume Dan Shen?

Q: Can Kidney Disease Patients Safely Consume Dan Shen?

Dear User/40/1, Hello： 1. A 76-year-old male patient with kidney disease has normal potassium, phosphorus, and sodium levels. Currently, he is strictly controlling protein intake as well as potassium, phosphorus, and sodium. Given that your current GFR is appr

Can patients with kidney disease consume ginseng?

Hello, I would like to inquire if a patient with kidney disease can consume Dan Shen (Salvia miltiorrhiza).
The current GFR is approximately 28, and the patient is a 76-year-old male.
Potassium, phosphorus, and sodium levels are all normal.
The patient is currently on a strict diet controlling protein, potassium, phosphorus, and sodium intake.
However, due to frequent headaches and concerns about the risk of stroke, he is considering taking Dan Shen for health maintenance.
I would appreciate your guidance on whether this is appropriate.
Thank you very much!

Qiúzhù zhě, 40~49 year old female. Ask Date: 2012/03/23

Dr. Lin Qingzhong reply Traditional Chinese Medicine

Dear User/40/1,
Hello:
1.
A 76-year-old male patient with kidney disease has normal potassium, phosphorus, and sodium levels.
Currently, he is strictly controlling protein intake as well as potassium, phosphorus, and sodium.
Given that your current GFR is approximately 28, according to renal pathology, a GFR of 15-29 ml/min/1.73 m² indicates severe renal failure, classified as stage 4 chronic kidney disease, and preparation for dialysis treatment is necessary.

2.
In cases of chronic kidney disease, with slightly elevated BUN, creatinine, and potassium levels, traditional Chinese medicine (TCM) may be used to alleviate the rapid deterioration of the condition.
Treatment should be tailored based on the patient's condition and symptoms.
However, if the patient has reached the uremic stage (CCR < 5; GFR < 15 ml/min/1.73 m²), this indicates end-stage renal failure, requiring dialysis or kidney transplantation, classified as stage 5 chronic kidney disease.
If renal function has deteriorated to uremia, no medication, whether traditional or Western, can reverse the extent of renal failure.
Do not hesitate; it is imperative to start dialysis promptly, as the correct medical intervention is essential for preserving life.

3.
The herbal formula Dan Shen, combined with Si Wu, is not recommended for self-administration, especially if you have experienced headaches and concerns about stroke.
It is best to consult a qualified TCM practitioner for diagnosis and treatment tailored to your specific condition and constitution.
In clinical practice, for patients with renal failure that has progressed to uremia, it is crucial to continuously monitor BUN, creatinine, potassium, and GFR levels to improve the condition and prevent further deterioration.

4.
If you have reached the uremic stage, no medication, whether traditional or Western, can alter the course of renal failure.
Do not hesitate; it is crucial to begin dialysis immediately, as the correct medical approach is vital for sustaining life.

Wishing you well,
Dr.
Lin Qingzhong,
Director of Traditional Chinese Medicine, Fengyuan Hospital
Assistant Professor, Hungkuang University

Reply Date: 2012/03/23

More Info

Dan Shen, also known as Salvia miltiorrhiza, is a traditional Chinese medicinal herb that has been used for various health conditions, particularly for its potential cardiovascular benefits. However, when it comes to patients with kidney disease, especially those with a GFR (glomerular filtration rate) of approximately 28, caution is warranted.

For patients with chronic kidney disease (CKD), particularly those in stage 4 (which corresponds to a GFR of 15-29 mL/min), the kidneys are significantly impaired in their ability to filter waste products from the blood. This impairment can lead to an accumulation of substances that would normally be excreted, and the use of certain herbal supplements, including Dan Shen, may pose risks.

Potential Benefits of Dan Shen
Dan Shen is known for its properties that may improve blood circulation and reduce inflammation. Some studies suggest that it may have protective effects on the cardiovascular system, which could be beneficial for patients at risk of cardiovascular events, including those with kidney disease. Additionally, Dan Shen has been studied for its potential to improve microcirculation and reduce oxidative stress, which are important factors in kidney health.

Risks and Considerations
1. Potassium Levels: Although you mentioned that your potassium levels are normal, Dan Shen has been reported to potentially influence potassium levels. In patients with kidney disease, even slight fluctuations in potassium can lead to serious complications, including cardiac arrhythmias.

2. Drug Interactions: Dan Shen can interact with various medications, particularly anticoagulants and antiplatelet drugs. If you are on any medications for blood pressure, diabetes, or other conditions, it is crucial to consult with your healthcare provider to avoid adverse interactions.

3. Kidney Function Monitoring: Given your current GFR and the fact that you are managing your diet strictly, any new supplement should be approached with caution. Regular monitoring of kidney function and electrolytes is essential when introducing any new treatment.

4. Underlying Conditions: Your concern about headaches and the fear of stroke is valid. However, it is essential to address the underlying causes of these symptoms with your healthcare provider rather than self-medicating with herbal supplements. Headaches can have various causes, including hypertension, dehydration, or other neurological issues, and should be evaluated by a physician.

Conclusion
While Dan Shen may offer some potential benefits, the risks associated with its use in patients with significant kidney impairment cannot be overlooked. It is crucial to have a thorough discussion with your nephrologist or healthcare provider before starting any new supplement, including Dan Shen. They can provide personalized advice based on your overall health status, current medications, and specific kidney function.

In summary, while some patients with kidney disease may safely use Dan Shen under medical supervision, it is essential to weigh the potential benefits against the risks and to ensure that any treatment plan is tailored to your individual health needs. Always prioritize open communication with your healthcare team to make informed decisions about your health.

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