Kampo Medicine for Supporting Kidney Transplantation and Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is a progressive condition often requiring dialysis or transplantation. While ACE inhibitors and SGLT2 inhibitors help delay disease progression, they offer limited relief for symptoms such as fatigue, edema, and muscle cramps. Kampo medicine, rooted in traditional Japanese herbal therapy, may offer a complementary approach. Shakuyakukanzoto provides rapid relief for leg cramps in dialysis patients. Hachimijiogan, and goshajinkigan are beneficial for symptoms associated with kidney deficiency, including coldness, edema, and nocturia. Juzentaihoto has immunomodulatory effects and may improve fatigue and immune function in pre- and post-transplant patients. Astragalus membranaceus (ougi), a key ingredient in several formulas, has been reported to protect kidney function through anti-inflammatory and anti-fibrotic effects, with meta-analyses showing improvement in eGFR and reductions in proteinuria. We previously reported a case using Yojinkodakuto, an Astragalus membranaceus-containing decoction, in an 82-year-old man with end-stage CKD. Kampo treatment was associated with marked improvement in serum creatinine (from 3.76 to 2.10 mg/dL) and eGFR (from 10.9 to 26.5 mL/min/1.73m²) over six months. The formula addresses “Qi and Yin deficiency” and “turbid toxins,” and its success may be attributed to personalized modifications based on Kampo diagnostics. These findings suggest Kampo medicine may contribute to symptom control, kidney function preservation, and improved quality of life in CKD patients, especially when personalized appropriately.