Chronic Kidney Disease (Adjunct)
Also known as: Chronic kidney disease, CKD, Chronic renal disease, Chronic renal impairment, Reduced kidney function, Albuminuria, Proteinuric kidney disease, Diabetic kidney disease, Hypertensive kidney disease
Chronic kidney disease is defined by abnormalities of kidney structure or function persisting for at least three months, classified by cause, estimated glomerular filtration rate category and albuminuria category. Early CKD is often asymptomatic and is usually detected through blood pressure assessment, serum creatinine with eGFR, and urine albumin-to-creatinine ratio. Diabetes, hypertension, cardiovascular disease, glomerular disorders, inherited kidney disease, recurrent acute kidney injury and obstructive uropathy are important causes or risk factors. Management focuses on treating the underlying cause, controlling blood pressure and albuminuria, reducing cardiovascular risk, avoiding nephrotoxins, adjusting medicine doses to kidney function, monitoring complications and arranging nephrology referral when indicated; kidney replacement therapy may be required in advanced kidney failure. In Chinese medicine, CKD presentations overlap with Shuǐ Zhǒng (水肿), Lóng Bì (癃闭), Xū Láo (虚劳), Yāo Tòng (腰痛), Xuàn Yūn (眩晕) and Guān Gé (关格), commonly involving Spleen Qi or Yang deficiency, Kidney Qi or Yang deficiency, Spleen–Kidney Yang deficiency with water retention, Liver–Kidney Yin deficiency, Qi and Yin deficiency, Damp-Heat and Blood stasis. Acupuncture and Chinese herbal medicine are adjunctive supportive care only and must not replace nephrology assessment, renoprotective medicines, dialysis, transplantation planning or electrolyte management.
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Lifestyle & Diet
- •Follow the nephrologist's management plan and take prescribed medicines consistently.
- •Monitor blood pressure regularly and maintain optimal diabetes management where applicable.
- •Avoid smoking and vaping, and maintain physical activity within individual tolerance.
- •Attend scheduled renal blood and urine monitoring.
- •Follow individual renal dietitian advice; do not alter potassium, phosphate, sodium or protein intake without medical guidance.
- •Maintain prescribed fluid restrictions where applicable.
- •Avoid unregulated herbal supplements and bodybuilding products.
- •Protect dialysis access, never needle a limb containing a fistula or graft, and coordinate treatment around dialysis sessions.
- •Follow transplant team recommendations after renal transplantation.
Cautions & Contraindications
- •Never needle an arm containing an arteriovenous fistula or graft — risk of vascular injury and loss of dialysis access.[,]
- •Avoid deep needling over a transplanted kidney because of injury risk.[]
- •Unsupervised herbal medicine is unsafe in CKD due to potential nephrotoxicity, electrolyte disturbance and medicine interactions; qualified prescribing only, with exclusion of restricted herbs such as Má Huáng (Ephedra) and Fù Zǐ (Aconite).[,]
- •Do not claim that acupuncture or herbal medicine reverses or cures chronic kidney disease; use adjunctive supportive care language only.[]
- •Avoid strong reducing techniques in frail or dialysis patients, which may worsen fatigue or hypotension.[]
- •Do not needle immediately before or after haemodialysis without assessment — increased risk of hypotension, bleeding and fatigue; individualise treatment timing.[]
When to reassess or seek care again
- •Initial visit: confirm CKD stage and cause, review recent eGFR and urine albumin-to-creatinine ratio, record blood pressure, medicines and dialysis status.
- •Initial visit: assess oedema, fatigue, appetite, pruritus and sleep, and review cardiovascular history and diabetes management.
- •Every visit: screen for red flags and monitor changes in oedema, blood pressure, fatigue and functional capacity.
- •Ongoing: review medicine changes including ACE inhibitors, ARBs, SGLT2 inhibitors, diuretics and anticoagulants, and document dialysis schedule and vascular access status.
Coordinate care with the nephrologist and GP. Useful outcome measures include patient-reported fatigue, blood pressure, quality-of-life measures, functional capacity, sleep quality, pruritus severity and oedema severity.
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- Kidney Health Australia
- Kidney Disease: Improving Global Outcomes
- Healthdirect Australia
- National Institute of Diabetes and Digestive and Kidney Diseases
- Kidney Health Australia
- Australian Health Practitioner Regulation Agency
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.