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Travis Spire-Sweet, LAc, Dipl. OM.
Traditional Chinese MedicineAnd Chronic Kidney Disease
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Overview
Cultural Development of Nephrology
Aristolochic Acid and Chinese Herbal Nephropathy
Nephrotoxic over the counter herbs
Traditional Chinese medicine’s treatment of kidney disease Acupressure Acupuncture Single Herbs Formulas
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Cultural Development of Nephrology
HuangDi NeiJing – Yellow Emperors Classics Of Medicine
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Cultural Development of Nephrology
Egyptian Mummies: Kidneys and Hearts only organs saved
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Cultural Development of Nephrology
Mayan culture’s use of herbs and stones in kidney ailments
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1,600 women received this particular weight loss therapy
100 ended up having cancer or ESRD
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14Nephrotoxic Over the Counter Herbs
Pyrrolizidine Alkaloid Containing Species6
• Borage (Borago officinalis) • Comfrey (Symphytium species), • Coltsfoot (Tussilago farfar), • Liferoot (Senecio aureus).2
Chinese herbs that contain pyrrolizidine alkaloids are:• Kuang Dong Hua (Flos Tussilaginis farfarae),• Pei Lan (Herba Eupatorii fortunei), • Qian Li Guang (Senecio scandens), • Zi Cao (Radix Arnebiae seu Lithospermi)3
15Nephrotoxic Over the Counter Herbs
Herbal Aquaretics2
• Tian Men Dong (Tuber Asparagi cochinchinensis) • Gan Cao (Radix Glycyrrhizae uralensis), • Horseradish(Radix Armoracia rusticana), • Juniper berry(Fructus Juniperus communis), • Lovage root (Radix Levisticum officinale), • White sandalwood (Santalum album), • Watercress (Nasturtium officinale)
16Nephrotoxic Over the Counter Herbs
Licorice (Radix Glycyrrhizae uralensis) 2,4,5
Commonly given in formulasand as a single herb.
Excessive licorice consumptioncan lead to pseudoaldosterism
17Nephrotoxic Over the Counter Herbs
Ephedra (Herba ephedra) 2,4,7
Increases blood pressure
Potentially contributes to kidneystones
18Nephrotoxic Over the Counter Herbs
St. John’s Wort (Hypericum perforatum) 4,8
Competes with immunosuppressiveDrugs
Also changes how immunosuppressivedrugs are broken down and theirbyproduct
19Traditional Chinese medicine’s treatment of kidney disease
Acupressure
Acupuncture
Single Chinese Herbs
Herbal Formulas
Treatment Modalities:
20Acupressure
Acupressure is the manual administration of force to an acupuncture point or channel by a finger, hand, elbow, or other instrumentation.
21Acupressure
Fatigue and Depression 9,10
Insomnia 11,12,13,14
Pruritus 15,16
Diabetic Neuropathy 17
Acupressure benefits with kidney disease:
Acupuncture
Acupuncture
Acupuncture
27Acupuncture
Acupunctures benefits with kidney disease:
Decrease Blood Pressure18
Slows Progression of Kidney Disease19,20,21
Relieves Pruritus22
Ameliorates Diabetic Neuropathy23
Decreases sympathetic nerve activityIn kidney24,25,26
Pain Management27,28
Alters Renal Blood Flow29,30
28Single Chinese Herbs
Cordyceps Sinensis
Tryptergerium Wilfordii
Salvia Miltiorrhiza
Radix et Rhizoma Rhei
Radix Astragali
29Cordyceps sinensis
Inhibits Inflammatory Pathway of Kidney Disease31
Prevents Nephrotoxicities31,32,33,34,35,36,37
Slows Progression of Chronic Kidney Disease38,39,40
Ameliorates Damage from ischemia reperfusion41,42,43
30Tryptergerium Wilfordii
• Acts a potent Immunosuppressant
• Decreases Proteinuria in multiple forms of chronic kidney disease 48
Nephrotic Syndrome 44,45
IgA Nephropathy 46
Potential therapy for renal transplant 47
31Salvia miltiorrhiza
Decreases proteinuria, glomerular sclerosis, and tubular interstitial lesions by inhibiting TGF-Beta 49,50,51,52
Lowers BUN and Scr in CKD patients49,50,51,52
Inhibits ROS by Increases serum SOD and catalase49,50,51,52
Lowers blood pressure, via ACEi, atrial natriuretic peptide, eNOS 53,54
Increases renal blood flow51
Acts as a xanthine oxidase inhibitor, prevent gout55
32Salvia miltiorrhiza
Lessen diabetic nephropathy after onset56
Prevent kidney stone formation57
33Radix et Rhizoma Rhei
• Protective effect with CKD patients49,50,52,58
Decrease Proteinuria
Decrease Scr
Decrease severity of glomerulosclerosis
Decrease monocyte infiltration in remnant glomeruli
Inhibits proliferation of mesangial cells
34Radix et Rhizoma Rhei
Increases survival rate of chronic kidney disease patients52
Prevents progression of renal disease when combined with angiotensin inhibitors59
Decreases adverse effects of dialysis (pruritus) 52
35Radix Astragali
Decreases proteinuria 52,60,61,62
Anti-Diabetic (decreases fasting serum glucose, increases albumin levels) 52,61Increases Creatinine Clearance, decrease Scr62
Increase hemoglobin62
Decreases blood pressure62
36Chinese Herbal Formulas
Chai Ling Tang
Jin Gui Shen Qi Wan
Dang Gui Bu Xue Tang
37Chai Ling Tang
Reduces autoimmune response in diseases such as rheumatoid arthritis 66
Reduces chances of acute rejection in kidney transplant. Every herb in this formula is important in it’s anti-rejection capability 84
Reduces proteinuria in acute glomerulonephritis (Lupus and IgA) 49,63,64,65
Decreases proliferation of mesangial cells and inhibits progression of renal damage during acute kidney diseases 49,63,64,65
Alters immune function – prevents alloimmune and autoimmune spontaneous abortion 67
38Jin Gui Shen Qi Wan
Decreases Renal Oxidative Stress and dyslipidemia 68,69,70,71,72
Decreases Blood Pressure 73,74
Ameliorates diabetic nephropathy 75,76,77,78,79,80,81,82,85
Decrease renal hypoxia damage 83
39Dang Gui Bu Xue Tang
Decreases glomerular tubulointerstitial injury via inhibition of TGF-Beta86
Decreases Extra Cellular Matrix precursors via activation of VEGF 87
Increases renal protective effect of enalopril88
Decreases vasopressin does not act as a ACEi 88
Induces EPO expression via HIF pathway 89
Decreases hyperlipidemia and proteinuria in nephrotic syndromes50,90
Unique preparation accounts for bioactivity of formula (5:1) 91,92
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APOL-1 Genetic Mutation 93,94,95
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