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Renal failure is a syndrome characterized by a decrease in kidney function caused by various reasons, leading to metabolic disturbances and multi-system symptoms. It is mainly divided into acute kidney injury (AKI) and chronic renal failure (CRF), with some patients experiencing acute kidney injury on the basis of chronic renal failure. The main treatment methods for renal failure patients include preventing and treating the underlying causes, controlling complications, and renal replacement therapy.
Acute Kidney Injury
Prerenal Acute Kidney Injury
Various factors can cause prerenal acute kidney injury, such as surgery, trauma, dehydration, shock, massive bleeding, heart failure, sepsis, renal vascular diseases, leading to a relative or absolute decrease in effective blood volume, reduced renal blood flow, and decreased glomerular filtration rate.
Renal Acute Kidney Injury
Renal acute kidney injury is mainly caused by renal parenchymal injury. Ischemia, nephrotoxic substances, atypical blood transfusions, infections, drug allergies, hypercalcemia, glomerulonephritis, tubular necrosis, vasculitis, acute systemic lupus erythematosus, and other conditions can cause acute kidney injury. Nephrotoxic substances include drugs (such as antibiotics, certain chemotherapeutic drugs, etc.), contrast agents, heavy metals, snake venom, etc.
Postrenal Acute Kidney Injury
Postrenal acute kidney injury can be caused by various conditions leading to acute urinary tract obstruction, including stones, tumors, blood clots, and prostate enlargement.
Chronic Renal Failure
Common primary causes include chronic nephritis, diabetes, hypertension, etc. Among them, primary glomerular diseases, diabetic nephropathy, and hypertensive arteriolar sclerosis are the three main causes of chronic renal failure.
Acute Kidney Injury
During the initial stage of acute kidney injury, patients may have no symptoms, or may only present with symptoms such as dizziness and nausea caused by hypotension and ischemia.
During the maintenance phase, the main symptoms include oliguria or anuria, generalized edema, decreased appetite, nausea, vomiting, dyspnea, arrhythmias, mild anemia, and multi-system symptoms.
In the recovery phase, some patients may experience polyuria, which gradually returns to normal after a period of time.
Chronic Renal Failure
Chronic renal failure mainly manifests as electrolyte and acid-base balance disorders, as well as multi-system symptoms including digestive system issues (loss of appetite, nausea, vomiting, etc.), respiratory system problems (shortness of breath, dyspnea, etc.), cardiovascular system issues (high blood pressure, arrhythmias, etc.), nervous system problems (fatigue, headache, mental fatigue, etc.), blood system issues (anemia, etc.), and renal osteodystrophy, etc.
For life-threatening fluid and electrolyte imbalances caused by acute kidney injury, doctors will immediately initiate appropriate treatment. For patients who still exhibit the following conditions despite receiving appropriate internal medicine treatment, early dialysis may be necessary.
The patient has excessive fluid overload.
The patient develops hyperkalemia (serum potassium >5.5mmol/L) or a rapid increase in serum potassium.
Uremic symptoms, such as pericarditis or unexplained mental status decline due to other reasons.
Severe metabolic acidosis.
Chronic renal failure falls within the scope of Traditional Chinese Medicine's "nourishing toxicity," "deficiency fatigue," and "kidney blockage."
Chinese Herbal Therapy
Spleen-kidney Qi deficiency syndrome
Manifestations: fatigue, shortness of breath, decreased appetite, lassitude, soreness and weakness of the lumbar region and knees, abdominal distension, reduced bowel movements, slight thirst, pale tongue with teeth marks, and deep, thready pulse.
Treatment: tonify Qi, invigorate spleen, and strengthen kidneys.
Spleen-kidney Yang deficiency syndrome
Manifestations: aversion to cold, cold limbs, fatigue, shortness of breath, decreased appetite, lassitude, soreness and weakness of the lumbar region and knees, cold and painful lumbar region, abdominal distension, reduced bowel movements, nocturia, pale tongue with teeth marks, and deep, weak pulse.
Treatment: warm and tonify spleen and kidneys, and invigorate Yang Qi.
Spleen-kidney Qi-Yin deficiency syndrome
Manifestations: fatigue, soreness and weakness of the lumbar region and knees, dry mouth and throat, restlessness, nocturia, pale tongue with teeth marks, and deep, thready pulse.
Treatment: tonify Qi and nourish Yin.
Liver-kidney Yin deficiency syndrome
Manifestations: dizziness, headache, soreness and weakness of the lumbar region and knees, dry mouth and throat, restlessness, dry stools, reduced urine with dark color, pale tongue with scanty coating, and deep or wiry pulse.
Treatment: nourish and tonify liver and kidneys.
Yang-Yin dual deficiency syndrome
Manifestations: aversion to cold, restlessness, dry mouth and throat, soreness and weakness of the lumbar region and knees, nocturia, dry stools, pale tongue with teeth marks, and deep, thready pulse.
Treatment: dual tonification of Yang and Yin.
Fumigation and Application Therapy
Soak the medicinal herbs in water, place them in a cloth bag, and apply the herbal bag for hot fumigation on the bilateral Shenshu and Guanyuan acupoints, once or twice daily. A course of treatment lasts for three months and can achieve the effects of nourishing qi and promoting blood circulation, warming Yang, and promoting diuresis.
Acupuncture Therapy
Use acupoints Zhongwan, Qihai, Zusanli, Sanyinjiao, Shenshu, Sanjiaoshu, and Xinshu to tonify Qi and blood. Use acupoints Guanyuan, Zhongji, Yinlian, Shenshu, Sanjiaoshu to promote diuresis. Use acupoints Dazhui, Mingmen, Shenshu, Pishu, Zhongwan, Zhongji, Zusanli, and Sanyinjiao to tonify spleen and kidneys.
Medicated Bath Therapy
Medicated bath is an auxiliary method for treating chronic renal failure.
After wrapping the herbal medicine in a bag, place it in a steam therapy device for 30 to 45 minutes of steaming, achieving the purpose of sweating without fatigue, three times a week. This method can further eliminate toxins, assist in correcting hypertension and azotemia.
In daily life, patients need to pay attention to medication taboos, and when necessary, consult a professional doctor. If there are underlying conditions such as hypertension or diabetes, active treatment should be pursued, while maintaining a cheerful mood and actively facing the disease and life.
At the same time, family members should pay attention to the patient's emotional changes and communicate in a timely manner. For the families of elderly patients, attention should be paid to changes in the patient's body, and if there is any discomfort, prompt medical attention should be sought.
When chronic kidney disease (CKD) is present, the following measures can be taken to protect the kidneys:
If prescribed antihypertensive and other medications, take them daily.
If diabetic, maintain blood sugar within the normal range.
If dietary changes are recommended, follow the instructions.
Quit smoking if you are a smoker.
Lose weight if you are overweight.
Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs).
Before starting any new medication (even over-the-counter drugs), confirm with a doctor, nurse, or nephrologist.
In addition, pay attention to rest, maintain a healthy diet, and monitor your own physical condition. If diagnosed with kidney disease or conditions that may cause kidney damage, regular check-ups for urine routine and kidney function at least twice a year are recommended to detect chronic renal failure at an early stage. It is also advisable for healthy individuals to undergo screening once a year to prevent and control the condition.
