Chinese medicine for diabetic kidney disease in China

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Diabetic kidney disease (DKD) is one of the most severe microvascular complications of diabetes and the leading cause of end‐stage renal disease (ESRD) in developed countries. In 2013, incidence of ESRD due to DKD in the United States and Japan was 45.9%1 and 43.8%,2 respectively.
Current evidence shows that early administration of angiotensin‐converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB), improvement in glycaemic control and lipid‐lowering therapy are the first‐line treatment for managing DKD.3 Unfortunately, these treatments have some disadvantages: ACEI/ARB are contraindicated for patients with severe renal impairment and have severe side effects4; intensive blood glucose control can lead to hypoglycaemia5; and studies evaluating the renoprotective effect of statin therapy on DKD have contradictory findings.6 Chinese medicine (CM) is a source of medical knowledge gained from clinical experience. Literature records of CM treating proteinuria and oedema, which are the key clinical manifestations of DKD, can be traced back to the Han dynasty (206 BCE to 220 CE). This theory has been refined over long empirical practice, resulting in diverse and numerous forms of treatments. This article reviews modern treatments of DKD with CM based on literature reports.
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