Recently, at the inaugural meeting of the Kidney Disease Dialysis Branch of the Hebei Association of Traditional Chinese Medicine in 2023, Professor Tan Jinchuan, chairman of the conference, emphasized:It is necessary to break the erroneous thinking that it is not recommended to apply traditional Chinese medicine after stage 3 of chronic kidney disease, and realize the integration of the whole stage**.
In the past, we have always considered that stage 1-3 is safe in the process of applying oral Chinese medicine**, and there will be a risk of high potassium after stage 3. At this conference, the participating experts reached a consensus:Kidney disease in the middle and late stages is not a contraindication to traditional Chinese medicine, and hyperkalemia can be avoided as long as prevention is done.
On the one hand, low-potassium herbs are selected
In 2004, the Chinese Journal of Integrative Medicine Nephrology published the "Analysis of Potassium Content of Commonly Used Chinese Medicine Decoctions", and the results showed that:
Among the 308 commonly used Chinese medicines, 134 have a higher potassium content, mostly seen in flowers and leaves of traditional Chinese medicine;However, roots, stems, animals, insects, ores, fruits and seeds have a lower potassium content.
More than half of the commonly used Chinese herbal medicines have safe potassium content, which gives clinicians room to adjust their prescriptions.
For example, among the Chinese medicinal materials for chronic renal failure, Pseudostellaria radix, Astragalus membranaceus, Rhubarb, Morinda officinalis, Huai Yam, Chuanxiong, and San.
7. Chuanyi, Zhuling, Zeeland, red peony, etc., have low potassium content and guaranteed safety. Even with the addition of two potassium-rich herbs such as safflower, June snow, etc., the patient's blood potassium can still be well controlled.
The human body itself needs potassium, and it needs 4 grams of potassium per day. The decoction of Chinese medicine for kidney failure can control the potassium content at 0About 8 grams, only 20% of the potassium required by the human bodyCombined with the prescription of a low-potassium diet, not only will the potassium not be increased during the process of professional nephrology TCM**, but the blood potassium level will be lower than the baseline.
There are two main ways of administering traditional Chinese medicine: internal and external. Walking on two legs is indispensable, and this is also the consistent policy of our hospital. And external use can effectively prevent the body from absorbing large amounts of potassium.
The earliest classic of traditional Chinese medicine, "The Yellow Emperor's Neijing: Suwen", introduced the external treatment method of traditional Chinese medicine, and the classics of the past dynasties have been inherited. On the basis of inheriting the essence of external treatment of the ancestors and summarizing the experience of kidney disease, modern Chinese medicine has developed various methods for external treatment of kidney disease, such as meridian acupoint compress ironing, Chinese medicine steam bath, Chinese medicine fumigation and Chinese medicine colon dialysis, and published works such as "Meridian Acupoint Compress and Ironing ** Kidney Disease" and "Basic and Medication Guide for External Chinese Medicine Preparations".
This enriches and standardizes the content of traditional Chinese medicine in the treatment of kidney disease through acupoints, brings more effective methods to patients with kidney disease, greatly improves the compliance of patients with kidney disease, and avoids the risk of high blood potassium.
In short, on the basis of syndrome differentiation and treatment, we consider the potassium content of various traditional Chinese medicines, combined with a safer and more effective administration method, and the hyperkalemia caused by traditional Chinese medicine can be avoided.
The current problem is that controlling the potassium content of traditional Chinese medicine prescriptions and opening three-dimensional drug delivery channels will increase the learning and workload of clinical doctors, as well as increase medical costs. At present, only some experienced TCM physicians and TCM hospitals that attach importance to nephrology will reduce potassium intake and improve kidney damage for patients with stage 3 renal failure.
For hundreds of millions of people with chronic kidney disease and millions of people on uremic dialysis in China, professional kidney TCM medical resources are still insufficient, and they urgently need to be supplemented and popularized in order to contribute more to improving kidney function, which is also an important purpose of the recent establishment of the TCM Nephrology Dialysis Branch.
Western medicine is good at acute diseases, Chinese medicine is good at chronic diseases, and chronic kidney disease has always been an advantageous area of Chinese medicine. However, due to the high potassium content of some traditional Chinese medicines, some patients with kidney failure who receive traditional Chinese medicines** have hyperkalemia***
Therefore, our friends with kidney failure, as well as those who are taking drugs with potassium-raising effects (such as prisartan, spironolactone, etc.), must learn from the lessons summarized by our predecessors. When seeking traditional Chinese medicine, on the one hand, ask a professional nephrology TCM physician to check the potassium content of traditional Chinese medicine, and on the other hand, reduce oral and combined external methods when using drugs to avoid the occurrence of hyperkalemia, so as to give full play to the advantages of traditional Chinese medicine in improving kidney function.