CLINICAL APPLICATIONS

* Chronic nephritic syndrome (nephritis, glomerulonephritis)

* Chronic nephrotic syndrome (nephropathy)

* Chronic kidney disease with signs and symptoms such as proteinuria, edema, soreness of the lower back, fatigue, emaciation, flabby tongue, greasy tongue coating, deep, thready or wiry pulse

* Note: This formula is not recommended for acute kidney disorders.

 

WESTERN THERAPEUTIC ACTIONS

* Nephroprotective benefit to restore the normal filtration and excretion functions of the kidney

* Nephroprotective effect to reduce the presence of protein and blood in the urine

* Antifibrotic activity to improve ischemic microvasculature and attenuate interstitial fibrosis

* Diuretic effect to increase urine output and eliminate water accumulation

 

CHINESE THERAPEUTIC ACTIONS

* Dispels dampness

* Tonifies Kidney yin

* Tonifies qi

 

DOSAGE

Take 3 to 4 capsules three times daily with warm water. For maximum effectiveness, take the herbs on an empty stomach. This formula is safe for long-term use.

 

INGREDIENTS

Bai Mao Gen (Rhizoma Imperatae)

Du Zhong (Cortex Eucommiae)

Fu Ling (Poria)

Huang Bo (Cortex Phellodendri Chinensis)

Huang Qi (Radix Astragali)

Jin Ying Zi (Fructus Rosae Laevigatae)

Lu Xian Cao (Herba Pyrolae)

Mu Li (Concha Ostreae)

Shan Zhu Yu (Fructus Corni)

Shi Wei (Folium Pyrrosiae)

 

BACKGROUND

Chronic nephritic syndrome and chronic nephrotic syndromes are two common kidney disorders characterized by the presence of blood (hematuria) and protein (proteinuria), respectively. Though the exact pathophysiology differs, these two syndromes do have considerable clinical overlap, and may occur separately or concurrently. Causes of these kidney disorders include heredity, infection (bacterial, viral and others), immunologic (autoimmune disorder), and drug-induced (i.e., gentamicin, tobramycin, NSAIDs). Optimal treatment requires proper management of the signs and symptoms, and identification and eliminate of the cause if possible.

 

FORMULA EXPLANATION

Chronic nephritic syndrome and chronic nephrotic syndrome in traditional Chinese medicine are considered a complicated disease as it involves both excess and deficiency. The excess refers to the clinical manifestation of the illness, which is the accumulation of dampness and turbidity in the lower jiao. The deficiency refers to the underlying cause, which are Kidney qi and yin deficiencies. Most patients are extremely Kidney deficient. Since Kidney is the organ that stores jing (essence), deficiency of the Kidney leads to its inability to retain the jing (essence). As a result, the jing (essence) is leaked out from the body in the form of serum protein, albumin, immunoglobulins, red blood cells, blood and trace minerals.

        To treat patients with chronic nephritic syndrome and chronic nephrotic syndrome, Kidney DTX uses herbs to tonify the deficiency and drain the excess. Huang Qi (Radix Astragali) tonifies qi and regulates water metabolism in the body to reduce edema. Shan Zhu Yu (Fructus Corni) is sour, which consolidates Kidney jing (essence). It also has an excellent effect to tonify Kidney yin and jing (essence). Du Zhong (Cortex Eucommiae) tonifies the Kidney yang and strengthens the back to relieve soreness. Shi Wei (Folium Pyrrosiae) dispels dampness and stops bleeding in the urine. Lu Xian Cao (Herba Pyrolae) further helps to stop bleeding. Huang Bo (Cortex Phellodendri Chinensis) clears deficiency heat from the Kidney and reduces chronic inflammation. Fu Ling (Poria) and Bai Mao Gen (Rhizoma Imperatae) dispel dampness and promote urination to relieve edema. Bai Mao Gen (Rhizoma Imperatae) is frequently used for lin zheng (dysuria syndrome) to relieve blood in the urine. Fu Ling (Poria) and Bai Mao Gen (Rhizoma Imperatae) also help Huang Bo (Cortex Phellodendri Chinensis) to clear damp-heat in the lower jiao to dispel creatinine and blood urea nitrogen in the blood. Mu Li (Concha Ostreae) and Jin Ying Zi (Fructus Rosae Laevigatae) are astringent herbs used to prevent loss of Kidney jing (essence) through the urine. They also help to keep protein in the body and prevent the loss of protein and red blood cells through urine.

        Kidney DTX is an excellent formula to treat kidney disorder because it tonifies without causing stagnation and sedates without injuring the body¡¦s constitution. Furthermore, it contains herbs to treat the cause and the symptoms of the illness, thereby offering both immediate and long-term therapeutic benefits.

 

CAUTIONS & CONTRAINDICATIONS

* Kidney DTX is not suitable for acute kidney disorders. Such conditions should be referred to a medical doctor for immediate treatment.

* This formula is contraindicated during pregnancy and nursing.

 

CLINICAL NOTES

* To effectively treat kidney disorder, it is extremely important to identify and eliminate the cause(s). Disease conditions that are known to increase the risk and acceleration of kidney disorders, such as diabetes and lupus, must be properly controlled. Furthermore, certain drugs, toxins and heavy metals are known to cause kidney damage, and must be avoided as well. Examples of drugs include certain antibiotics, analgesics, and antiepileptics. Examples of environmental toxins include chemical solvents, biological agents, herbicides and pesticides. Examples of heavy metals include lead and cadmium. Avoidance of such factors will significantly improve both short- and long-term prognosis.

* It is prudent to monitor progress objectively with urine analysis. Such laboratory tests will confirm the effectiveness of the treatment and assist in the long-term treatment strategy.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Nephrotic syndrome and proteinuria characterized by Kidney yang deficiency: deep, stagnating, and weak pulse on the left chi.

* Chronic nephritis characterized by Kidney fire: the brachial pulse is deep, thick, big, forceful, and hard. The patient may also present with a superficial, forceful, hard, gu pulse on the right cun and a deep, chong pulse on the right chi. Gu refers to the jump of a pulse when both the upward and downward beat of the pulse can be felt. Chong pulse is a long, thick, straight pulse that extends proximally to the chi position; it is one of the eight extra meridian pulses.

 

SUPPLEMENTARY FORMULAS

* For accumulation of environmental pollutant, chemical compounds, and other toxins in the body, add Herbal DTX.

* For edema and water accumulation, add Herbal DRX.

* For unknown cause of symptoms with blood stagnation in patients with excess condition, add Circulation (SJ).

* For excess fire in the body, add Gardenia Complex.

* For wei (defensive) qi deficiency and frequent infections, add Immune +.

* For dry mouth, deficiency heat symptoms, tinnitus or dizziness, add Nourish or Nourish (Fluids).

* For Kidney yang deficiency with frequent urination especially at night, soreness, weakness and coldness of the lower back and knees, add Kidney Tonic (Yang).

* For Spleen qi deficiency with poor appetite, add GI Tonic.

* For high blood pressure, add Gastrodia Complex.

* With compromised liver function, add Liver DTX.

* With bleeding, add Notoginseng 9.

* To detox the colon, add GI DTX.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Sanyinjiao (SP 6), Zhigou (TH 6), Shuifen (CV 9), Guanyuan (CV 4), Feishu (BL 13), Hegu (LI 4), Zhongji (CV 3), Yinlingquan (SP 9), Zusanli (ST 36)

 

Classic Master Tung's Points:

* Nephritis (chronic): Tianhuangfu [Shenguan] (T 77.18), Dihuang (T 77.19), Renhuang (T 77.21), Huoying (T 66.03), Tongshen (T 88.09), Houzhui (T 44.02), Shouying (T 44.03), Shuixiang (T 66.14), Shuixian (T 66.15), Tongwei (T 88.10), Tongbei (T 88.11)  

* Pyelonephritis: Shuijin (T 1010.20), Shuitong (T 1010.19), Wanshunyi (T 22.08), Wanshuner (T 22.09), Tongshen (T 88.09), Tongguan (T 88.01), Houzhui (T 44.02), Shouying (T 44.03)

* Proteinuria: Tongshen (T 88.09), Tongwei (T 88.10), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Shuijin (T 1010.20), Shuitong (T 1010.19), Shuixiang (T 66.14), Shuixian (T 66.15), Tongbei (T 88.11)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Chronic nephritis, proteinuria, elevated creatinine, toxin in the Kidney: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

 

Balance Method by Dr. Richard Tan:

* Left side: Shenmen (HT 7), Lingdao (HT 4), Chize (LU 5), Feiyang (BL 58), Weizhong (BL 40)

* Right side: Zhubin (KI 9), Yingu (KI 10), Taichong (LR 3), Sanyangluo (TH 8), Kidney point on the ear, Linggu (T 22.05).

* Left and right sides can be alternated from treatment to treatment.

 

Ear Acupuncture:

* Kidney and surrounding tender points. Leave needles in for four to six hours. Needle once a day for seven days. Stop all diuretic medications while under ear acupuncture therapy.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Nephritis: Kidney, Nephritis Point, Endocrine, Adrenal Gland, Sympathetic, Spleen, San Jiao, Allergic Area, Coronary Vascular Subcortex. Bleed Ear Apex.

* Pyelonephritis: Kidney, Bladder, Urethra, Spleen, San Jiao, Adrenal Gland, Endocrine, Allergic Area. Bleed Ear Apex.

 

NUTRITION

* Intake of salt should be restricted to 1 to 2 grams per day, as excessive presence of salt will increase the severity of edema.

* Diet with restricted protein is recommended to reduce proteinuria and lower the stress on the kidneys. A high protein diet is discouraged since it accelerates the deterioration of kidney disease by increasing the intraglomerular pressure and urinary protein excretion.

* Vitamin D supplementation is encouraged in patients with clinical or biochemical evidence of vitamin D deficiency.

* Lotus nodes are recommended to be included in the diet.

* Do not eat sour and spicy foods.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Nephritis (acute)

¡± Recommendations: black beans, mung beans, azuki beans, pearl barley, garlic, carp, winter melon, watermelon, watermelon rind, corn-silk, sweet rice, lotus root, and water chestnuts.

¡± Cook soup with azuki beans, winter melon rind, watermelon rind and corn silk. Drink at least 3 to 4 times daily.

¡± Make tea from lotus root; drink four large glasses daily.

¡± Cook rice porridge with pearl barley, black beans, and water chestnuts.

¡± Make juice from carrots, celery, cucumbers, and squash.

¡± Avoid stimulating (sour, spicy, salty) foods, alcohol, caffeine, smoking, overworking, and high protein foods.

* Nephritis (chronic)

¡± Recommendations: ginger, Chinese black dates, sweet rice, soybeans, winter melon, carp, yams, mung beans, and black beans.

¡± Make rice porridge and add ginger, cinnamon, and Chinese black dates. Eat for breakfast and dinner.

¡± Cook rice porridge with yams and eat for breakfast and dinner.

¡± Steam together crab, garlic, and white wine. Eat once daily for fifteen days.

¡± Avoid stimulating (sour, spicy, salty) foods, alcohol, caffeine, smoking, overworking, and high protein foods.

 

LIFESTYLE INSTRUCTIONS

* Adequate rest is essential to recovery. Strenuous exercise increases the stress of the kidneys and accelerates their deterioration.

* To minimize stress on the kidneys, encourage elimination of toxins through the lungs, skin, and bowel. Practice breathing exercises, ensure regular bowel movements, and take hot baths.

* Avoid smoking and drinking.

 

CASE STUDIES

* C.P., a 63-year-old female, presented with multiple symptoms including low energy, pain located in the areas of the elbow, hip, back, and neck. Additional symptoms included the face and other parts of the body being puffy. Objective findings were BUN level of 53.0 mg/dL, creatinine level of 2.6 mg/dL, and calcium level of 12 mg/dL. The practitioner diagnosed this condition as Kidney yin deficiency with dampness, along with Kidney failure at stage three. She was prescribed Kidney DTX and was advised to change her diet to a low protein diet. After four months of taking the herbs, her BUN level became normal, the creatinine level dropped but were still slightly high, and the calcium levels became normal. The Western doctors involved with treating this patient were amazed at the change in values of BUN and creatinine as a result of the herbs. They had commented that they had never seen this happen before. Submitted by T. S. Tehachapi, California.

* W.P., a 45-year-old female, presented with pain in the kidney and liver areas. It was also noted that the patient had a history of Kidney infection and pancreatitis. She was also experiencing anxiety and depression, in regards to relationship issues. Pulse was weak and slightly slippery, and tongue was pale with a long center fissure. The practitioner diagnosed this condition as Liver qi stagnation with heat disturbing the shen (spirit), and toxins in the Kidney. Upon diagnosis the patient was prescribed Shine and Kidney DTX. Within four weeks of taking the herbs the patient had noticed her mood was stable and was no longer experiencing pain in the liver and kidney areas. The patient had also made lifestyle changes in her diet and received acupuncture one time a week. Submitted by T.W., Perrysburg, Ohio.

* L.T., a 64-year-old female, presented with the beginning of kidney declination due to taking both her anti-inflammatories and high blood pressure medications for 20 years. Blood pressure was 130/80 mmHg and her heart beat was 72 beats per minute. The TCM diagnosis was Kidney and Liver yin deficiencies; the Western diagnosis was kidney failure (beginning stage). Kidney DTX was prescribed and directed to take for nine months. After going and seeing a Western doctor and being offered minimal help with a negative outlook, the patient lived an additional three years, which had been more than the Western doctor had predicted. Submitted by J.L., San Diego, California.

* An 82-year-old male has been living with type 2 diabetes for the past 40 years, with hypertension developing in the last 10 years and kidney function degradation in the last six years. These conditions were managed by various Western Medicine medications. In January 2013, patient's kidney function degraded significantly to the point of near renal failure, with blood urea nitrogen (BUN) level rising to 88 mg/dL (normal range 7 to 21 mg/dL) and creatinine level rising to 2.1 mg/dL (normal range 0.6 to 1.30 mg/dL). The patient was consequently hospitalized for a week in late January and again in late February. After being discharged from the hospital in late February 2013, the patient started to be administered with two doses of Kidney DTX on a daily basis with each dose containing 5 capsules. By late March 2013, the BUN level has been steadily reduced to 36 mg/dL and creatinine level has also been reduced to 1.46 mg/dL. The patient also reported better stamina and overall energy level, and without additional changes to the Western medicine hypertension medications, average systolic blood pressure has also reduced from 180 mm Hg to 160 mm Hg. Submitted by T.C., Hacienda Heights, California.

* A 40-year-old female presented with slow mental functions. She answered questions slowly, and reported hot flashes, acid reflux after eating spicy foods, and a history of alcoholism and smoking. Objective findings revealed that her ankles were slightly swollen. The TCM diagnosis was toxic damp-heat accumulation with yin deficiency. Kidney DTX was prescribed for one month with Wu Pi Yin (Five-Peel Decoction) and Jia Wei Xiao Yao San (Augmented Rambling Powder). After one month, the swelling in her legs was down and the woman felt less brain fog. She wanted to drink more water and less alcohol. After six months of herbal, acupuncture and homeopathic treatment, she felt better all around. Submitted by M.C., Sarasota, Florida.

* A 51-years-old male had chronic recurrent nephritis for six years. In the past six months, the patient reported frequent urination at night (four to five times), soreness and pain of the lower back, tinnitus in both ears, fatigue, pale red and flabby tongue with teethmarks, white greasy tongue coat, and deep thready pulse. Objective tests confirmed the presence of protein (++) in the urine. The patient was diagnosed as qi and yin deficiencies of the Kidney with accumulation of dampness. After 50 days of herbal treatment, the patient reported a reduction of urination at night from four to five times down to one to two times, improvement of low back pain, reduction of tinnitus in the ears, and increased energy levels. Furthermore, urine analysis was negative for protein in three consecutive tests. The treatment was concluded to be effective. Submitted by W.J., Zhejiang, China.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Kidney DTX is a carefully crafted formula that treats chronic and generalized kidney disorders in which the filtering and excretion functions are compromised. Compromised kidney function is often evident with the presence of protein, blood cells, and fat in the urine. In addition, chronic nephritic syndrome and chronic nephrotic syndrome will also cause edema, especially in the lower parts of the body. The causes for such kidney disorders vary and may include conditions such as diabetes, lupus, use of certain drugs, exposure to certain toxins, and chronic heavy metal poisoning. Therefore, optimal treatment requires comprehensive herbal therapy with appropriate adjustments in both lifestyle and dietary habits. Kidney DTX is a comprehensive formula with many herbs that address all aspects of chronic and generalized kidney disorders. Herbs in Kidney DTX have been shown to restore normal functions of the kidneys, reduce protein in the urine, promote normal urination, and eliminate edema.

        Huang Qi (Radix Astragali) is used as the main herb in this formula, as it has a remarkable effect to treat kidney-related disorders, such as proteinuria, nephritis, nephropathy and glomerulonephritis. Pharmacologically, Huang Qi (Radix Astragali) exerts the nephroprotective effect by reducing fasting blood glucose and albuminuria levels, in reversing the glomerular hyperfiltration state, and in ameliorating the pathological changes of early diabetic nephropathy.[1] Administration of Huang Qi (Radix Astragali) via injection is associated with numerous benefits in patients with diabetic nephropathy, such as nephroprotective effect (BUN, SCr, CCr and urine protein) and systemic state improvement (serum albumin level).[2] One study showed that the oral use of Huang Qi (Radix Astragali) is effective to decrease the amount of protein present in urine.[3] Clinically, studies have also shown that Huang Qi (Radix Astragali) is effective in treating nephritis and glomerulonephritis by increasing the volume of urine and the elimination of chloride and ammonia.[4]^,[5] In one clinical trial, use of Huang Qi (Radix Astragali) twice daily for 15 to 90 days was effective in treating 16 out of 20 patients with nephritis. Most patients also reported symptomatic improvement as well as a decrease of protein in the urine.[6] Furthermore, in another clinical study with 56 patients with chronic glomerulonephritis, use of Huang Qi (Radix Astragali) by intramuscular injection for one month had a 61.7% effective rate in improving the function of the kidneys and reducing the amount of protein in the urine.[7] All these clinical results clearly indicate that the use of Huang Qi (Radix Astragali) is effective in treating kidney disorders.

        Huang Qi (Radix Astragali) is frequently used with other herbs for synergistic effect to treat various kidney disorders. In one study, the decoction of Huang Qi (Radix Astragali) and Dang Gui (Radix Angelicae Sinensis) shows marked effect to treat progressive chronic kidney disease by reducing proteinuria, decreasing the loss of capillaries, and improving microstructure dysfunction.[8] The nephroprotective effect is attributed in part to the antifibrotic activity of these two herbs to improve ischemic microvasculature and attenuate interstitial fibrosis.[9] In another study, twenty-one patients with type II diabetes with microalbuminuria were treated with the decoction of Huang Qi (Radix Astragali) and Chuan Xiong (Rhizoma Chuanxiong) by mouth at 150 mL daily. After six months, there was a significant decrease of urinary albumin excretion and an improvement of endothelial dysfunction. The mechanism of action may relate with the therapeutic effects of herbs on anti-inflammation, antioxidation, and alleviation of the hypo-fibrinolytic/pro-thrombotic state.[10] Lastly, one study found that the combination of Huang Qi (Radix Astragali) and Lu Xian Cao (Herba Pyrolae) was effective in preventing drug-induced kidney and ear damages.[11]

        Kidney DTX also contains herbs with marked diuretic effects since edema is a common complication of kidney disorder. Bai Mao Gen (Rhizoma Imperatae) has been shown to have a marked diuretic effect, especially if taken continuously for five to ten days.[12] Bai Mao Gen (Rhizoma Imperatae) has also been used in numerous formulas to successfully treat acute nephritis in adults and children.[13]^,[14] Fu Ling (Poria) also has a marked diuretic effect to increase urine output.[15] In one clinical study, 30 patients with edema were treated with a preparation of Fu Ling (Poria) three times daily for seven days, with marked effectiveness in 23 cases and moderate effects in 7 cases.[16] Lastly, the extract of Shan Zhu Yu (Fructus Corni) has been shown to induce diuresis, and that this herb may be beneficial for the prevention and treatment of diabetic nephropathy.[17]^,[18]

        In summary, Kidney DTX is formulated with many herbs that have marked effects to treat kidney disorders, such as proteinuria, nephritis, nephropathy and glomerulonephritis. These herbs have been shown to protect the kidney, regulate water circulation, eliminate edema, reduce the presence of protein in the urine, and restore the normal filtration and excretion function of the kidney.

 

COMPARATIVE ANALYSIS

Kidney diseases, such as chronic nephritic syndrome, chronic nephrotic syndrome and kidney failure, are serious and extremely complicated diseases. There are many potential causes of kidney diseases, and therefore, treatments vary depending on the exact etiology and prognosis. If the conditions continue to deteriorate, kidney dialysis, and eventually kidney transplant may become necessary. Kidney dialysis and transplant are generally considered to be the last options, but they do prolong life and offer additional hope.

        Treatment of kidney diseases is a very challenging and complicated matter. However, many herbs have been shown to have a marked effect to relieve stress for the kidney by promoting elimination of water and other unwanted substances. Furthermore, certain herbs have been shown to restore normal functions of the kidney, thereby offering hope of a life free from kidney dialysis and kidney transplant. However, herbs are generally only effective for early- to mid-stage of kidney diseases, and only for those with mild to moderate severity. Furthermore, herbs are more suitable for chronic kidney diseases, and are not recommended for acute kidney failure. Nonetheless, for patients on kidney dialysis who have no options other than kidney transplant, use of herbal therapy offers one additional hope and option.

        Kidney diseases are very challenging for both Western and traditional Chinese medicine. Both drugs and herbs offer hope to reverse the illness, especially in early stages of kidney diseases with mild to moderate severity. If the patient is already on kidney dialysis, it may still be worthwhile to explore herbal therapy, as there is a small possibility of recovery. When all else fails, kidney transplant is the final option.