st. lukes grand rounds
TRANSCRIPT
![Page 1: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/1.jpg)
1
Travis Spire-Sweet, LAc, Dipl. OM.
Traditional Chinese MedicineAnd Chronic Kidney Disease
![Page 2: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/2.jpg)
2
Overview
Cultural Development of Nephrology
Aristolochic Acid and Chinese Herbal Nephropathy
Nephrotoxic over the counter herbs
Traditional Chinese medicine’s treatment of kidney disease Acupressure Acupuncture Single Herbs Formulas
![Page 3: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/3.jpg)
3
Cultural Development of Nephrology
HuangDi NeiJing – Yellow Emperors Classics Of Medicine
![Page 4: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/4.jpg)
4
Cultural Development of Nephrology
Egyptian Mummies: Kidneys and Hearts only organs saved
![Page 5: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/5.jpg)
5
Cultural Development of Nephrology
Mayan culture’s use of herbs and stones in kidney ailments
![Page 6: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/6.jpg)
6
![Page 7: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/7.jpg)
71
![Page 8: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/8.jpg)
8
![Page 9: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/9.jpg)
9
![Page 10: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/10.jpg)
10
![Page 11: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/11.jpg)
11
![Page 12: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/12.jpg)
12
1,600 women received this particular weight loss therapy
100 ended up having cancer or ESRD
![Page 13: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/13.jpg)
13
![Page 14: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/14.jpg)
14Nephrotoxic Over the Counter Herbs
Pyrrolizidine Alkaloid Containing Species6
• Borage (Borago officinalis) • Comfrey (Symphytium species), • Coltsfoot (Tussilago farfar), • Liferoot (Senecio aureus).2
Chinese herbs that contain pyrrolizidine alkaloids are:• Kuang Dong Hua (Flos Tussilaginis farfarae),• Pei Lan (Herba Eupatorii fortunei), • Qian Li Guang (Senecio scandens), • Zi Cao (Radix Arnebiae seu Lithospermi)3
![Page 15: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/15.jpg)
15Nephrotoxic Over the Counter Herbs
Herbal Aquaretics2
• Tian Men Dong (Tuber Asparagi cochinchinensis) • Gan Cao (Radix Glycyrrhizae uralensis), • Horseradish(Radix Armoracia rusticana), • Juniper berry(Fructus Juniperus communis), • Lovage root (Radix Levisticum officinale), • White sandalwood (Santalum album), • Watercress (Nasturtium officinale)
![Page 16: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/16.jpg)
16Nephrotoxic Over the Counter Herbs
Licorice (Radix Glycyrrhizae uralensis) 2,4,5
Commonly given in formulasand as a single herb.
Excessive licorice consumptioncan lead to pseudoaldosterism
![Page 17: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/17.jpg)
17Nephrotoxic Over the Counter Herbs
Ephedra (Herba ephedra) 2,4,7
Increases blood pressure
Potentially contributes to kidneystones
![Page 18: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/18.jpg)
18Nephrotoxic Over the Counter Herbs
St. John’s Wort (Hypericum perforatum) 4,8
Competes with immunosuppressiveDrugs
Also changes how immunosuppressivedrugs are broken down and theirbyproduct
![Page 19: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/19.jpg)
19Traditional Chinese medicine’s treatment of kidney disease
Acupressure
Acupuncture
Single Chinese Herbs
Herbal Formulas
Treatment Modalities:
![Page 20: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/20.jpg)
20Acupressure
Acupressure is the manual administration of force to an acupuncture point or channel by a finger, hand, elbow, or other instrumentation.
![Page 21: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/21.jpg)
21Acupressure
Fatigue and Depression 9,10
Insomnia 11,12,13,14
Pruritus 15,16
Diabetic Neuropathy 17
Acupressure benefits with kidney disease:
![Page 22: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/22.jpg)
Acupuncture
![Page 23: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/23.jpg)
Acupuncture
![Page 24: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/24.jpg)
Acupuncture
![Page 25: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/25.jpg)
![Page 26: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/26.jpg)
![Page 27: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/27.jpg)
27Acupuncture
Acupunctures benefits with kidney disease:
Decrease Blood Pressure18
Slows Progression of Kidney Disease19,20,21
Relieves Pruritus22
Ameliorates Diabetic Neuropathy23
Decreases sympathetic nerve activityIn kidney24,25,26
Pain Management27,28
Alters Renal Blood Flow29,30
![Page 28: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/28.jpg)
28Single Chinese Herbs
Cordyceps Sinensis
Tryptergerium Wilfordii
Salvia Miltiorrhiza
Radix et Rhizoma Rhei
Radix Astragali
![Page 29: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/29.jpg)
29Cordyceps sinensis
Inhibits Inflammatory Pathway of Kidney Disease31
Prevents Nephrotoxicities31,32,33,34,35,36,37
Slows Progression of Chronic Kidney Disease38,39,40
Ameliorates Damage from ischemia reperfusion41,42,43
![Page 30: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/30.jpg)
30Tryptergerium Wilfordii
• Acts a potent Immunosuppressant
• Decreases Proteinuria in multiple forms of chronic kidney disease 48
Nephrotic Syndrome 44,45
IgA Nephropathy 46
Potential therapy for renal transplant 47
![Page 31: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/31.jpg)
31Salvia miltiorrhiza
Decreases proteinuria, glomerular sclerosis, and tubular interstitial lesions by inhibiting TGF-Beta 49,50,51,52
Lowers BUN and Scr in CKD patients49,50,51,52
Inhibits ROS by Increases serum SOD and catalase49,50,51,52
Lowers blood pressure, via ACEi, atrial natriuretic peptide, eNOS 53,54
Increases renal blood flow51
Acts as a xanthine oxidase inhibitor, prevent gout55
![Page 32: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/32.jpg)
32Salvia miltiorrhiza
Lessen diabetic nephropathy after onset56
Prevent kidney stone formation57
![Page 33: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/33.jpg)
33Radix et Rhizoma Rhei
• Protective effect with CKD patients49,50,52,58
Decrease Proteinuria
Decrease Scr
Decrease severity of glomerulosclerosis
Decrease monocyte infiltration in remnant glomeruli
Inhibits proliferation of mesangial cells
![Page 34: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/34.jpg)
34Radix et Rhizoma Rhei
Increases survival rate of chronic kidney disease patients52
Prevents progression of renal disease when combined with angiotensin inhibitors59
Decreases adverse effects of dialysis (pruritus) 52
![Page 35: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/35.jpg)
35Radix Astragali
Decreases proteinuria 52,60,61,62
Anti-Diabetic (decreases fasting serum glucose, increases albumin levels) 52,61Increases Creatinine Clearance, decrease Scr62
Increase hemoglobin62
Decreases blood pressure62
![Page 36: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/36.jpg)
36Chinese Herbal Formulas
Chai Ling Tang
Jin Gui Shen Qi Wan
Dang Gui Bu Xue Tang
![Page 37: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/37.jpg)
37Chai Ling Tang
Reduces autoimmune response in diseases such as rheumatoid arthritis 66
Reduces chances of acute rejection in kidney transplant. Every herb in this formula is important in it’s anti-rejection capability 84
Reduces proteinuria in acute glomerulonephritis (Lupus and IgA) 49,63,64,65
Decreases proliferation of mesangial cells and inhibits progression of renal damage during acute kidney diseases 49,63,64,65
Alters immune function – prevents alloimmune and autoimmune spontaneous abortion 67
![Page 38: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/38.jpg)
38Jin Gui Shen Qi Wan
Decreases Renal Oxidative Stress and dyslipidemia 68,69,70,71,72
Decreases Blood Pressure 73,74
Ameliorates diabetic nephropathy 75,76,77,78,79,80,81,82,85
Decrease renal hypoxia damage 83
![Page 39: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/39.jpg)
39Dang Gui Bu Xue Tang
Decreases glomerular tubulointerstitial injury via inhibition of TGF-Beta86
Decreases Extra Cellular Matrix precursors via activation of VEGF 87
Increases renal protective effect of enalopril88
Decreases vasopressin does not act as a ACEi 88
Induces EPO expression via HIF pathway 89
Decreases hyperlipidemia and proteinuria in nephrotic syndromes50,90
Unique preparation accounts for bioactivity of formula (5:1) 91,92
![Page 40: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/40.jpg)
40
APOL-1 Genetic Mutation 93,94,95
![Page 41: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/41.jpg)
41
References
![Page 42: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/42.jpg)
42
References
![Page 43: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/43.jpg)
43
References
![Page 44: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/44.jpg)
44
References
![Page 45: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/45.jpg)
45
References
![Page 46: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/46.jpg)
46
References
![Page 47: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/47.jpg)
47
References
![Page 48: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/48.jpg)
48
References
![Page 49: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/49.jpg)
49
References
![Page 50: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/50.jpg)
50
References
![Page 51: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/51.jpg)
51
References
![Page 52: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/52.jpg)
52
References
![Page 53: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/53.jpg)
53
References
![Page 54: St. Lukes Grand Rounds](https://reader035.vdocuments.us/reader035/viewer/2022062308/55cdf368bb61eb831b8b459a/html5/thumbnails/54.jpg)
54
References