Review of Traditional Chinese Medicines for Common Complications Related to Hemodialysis: An Evidence-Based Perspective

Abstract

Renal replacement therapy is an important therapy for prolonging life in end-stage renal disease (ESRD) populations, and, in Taiwan, hemodialysis (HD) is the choice for most patients with ESRD. Although HD is effective for prolonging life, it is sometimes associated with complications that patients and doctors have to cope with every day, such as intradialytic hypotension, dialysis disequilibrium syndrome, and muscle cramps. Traditional Chinese medicine (TCM) is a complementary and alternative therapy that has been recognized for its efficacy in treating a variety of diseases by the World Health Organization. Nowadays, the clinical practice of TCM for HD-related complications has received attention for its effectiveness and safety. In this article, we summarize the TCM viewpoint and different TCM interventions for HD-related complications, such as Chinese herbal medicine, acupuncture, herbal acupoint therapy, auricular acupoints, and moxibustion. In the ESRD population, TCM is able to balance Yin and Yang, prevent cardiovascular accidents, control blood pressure, and relieve pain. More importantly, TCM may also improve common HD-related complications such as uremic symptoms, imbalance of electrolyte and fluid status, insomnia, and malnutrition. The mechanism of TCM is considered related to the regulation of autonomous functions and the activation of biologically active chemical substances. According to the studies noted in this review article, TCM has been proven effective for HD-related complications. However, more well-designed and rigorous research will be necessary to reveal the underlying mechanisms in the future.

Prevalence and varieties of complementary and alternative medicine usage among individuals with pre-dialysis chronic kidney disease in Taiwan: an investigative cross-sectional analysis

“…This result shows that our pre-dialysis patients were less likely to seek non-prescribed CHM from herbal and supplement stores. Since 1995, the CHM prescribed by TCM practitioners under the NHI program has been mostly a scientifically-designed powder, which is convenient and well preserved, has a standardized GMP manufacturing process, and meets standards for heavy metals, flatoxin, and pesticide residues [ 56 ]. The prescribed CHM is known to reduce the mortality rate in patients with CKD by 40% as compared with non-users [ 57 ].…”

Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Hypotension in Patients with End-Stage Renal Disease: A Nationwide Population-Based Cohort Study

“…Especially, a de ciency of Yang-qi in Heart and Kidney may explain why clinical doctors choose those herbs as IDH treatments. For example, a recent review 20 noted that Shenfu decoction, Sheng Mai San (SMS), ginseng and Rx. Astragali are usually used for IDH to invigorate the Heart-and Kidney-qi.…”

“…TCM is commonly used by the Chinese population, with prevalence of 45.3% among patients with CKD 19 . There are reports of the e cacy of Chinese herbal medicine (CHM) in the treatment of HD-related complications such as hypotension, muscle cramps, and headache in Asian countries 20 . Given the lack of previous literature results on the use of TCM in the ESRD population, we conducted a case-control study by using the NHIRD to determine the protective effects of CHM in HD patients prescribed vasopressors, determine the prescribing pattern of common CHM, and analyze its relationship with hypotension risk.…”

Juan Bi Tang, a traditional Chinese medicine, for alleviating pain related to arteriovenous fistula in maintenance hemodialysis patients: An interventional pilot study with brief review

“…These effects can eventually cause pain around the arm with the fistula. [ 37 ] As mentioned before, JBT is basic therapeutic choice for many chronic diseases, especially painful conditions in asthenic patients. [ 24 ] The analgesic effect of JBT is believed to be linked to its main compounds, such as Rx.…”

“…Angelica Sinensis. [ 37 ] Previous small randomized controlled trials (RCTs) involving single herbs in herb-anticoagulant interactions have also been performed. [ 49 ] However, the complexity of clinical interventions in TCM means that it is virtually impossible conduct an RCT with a sufficiently large sample and long-term evaluation.…”