How to care for your kidneys

In our Western health culture, the kidneys are possibly the most neglected of the major organs. This pair of bean-shaped organs is located near the spine at the small of the back, just below the liver and spleen. Mainly responsible for the removal of urea, mineral salts, toxins and other waste products from the blood, they are seemingly behind us and out of sight, out of mind. Perhaps their association with excreting waste has led to a lack of polite conversation about them over the years. They’re not considered as “sexy” as, say, the liver with its infamous association with drugs, alcohol and partying.

Traditional Chinese Medicine (TCM), however, assigns the kidneys far greater influence on our health and wellbeing.

Western medicine

In Western medicine, the field of nephrology (from the Greek nephros for kidney) focuses very much on the diseases that affect the kidneys. Renal failure (renal is from the Latin for kidney) and dialysis (the process of filtering the blood outside of the body until a kidney donor can be found) are familiar terms relating to the kidneys’ failure through disease to remove wastes from the blood. Kidney diseases can be congenital or acquired. It’s possible for the human body to function with one working kidney.

A fully functioning kidney comprises more than a million active units of excretion know as nephrons. In each nephron, blood is filtered through a knot of capillaries into the Bowman’s capsule so that water, nitrogenous waste and other substances pass into the renal tubule. From here these substances are reabsorbed into the blood or collected in the duct that drains into the ureter and excreted as urine.

The kidneys are the prime regulating organs for the release back into the blood of sodium, potassium and phosphorus — a vital role, since the release of too much or too little can be harmful or even fatal. The kidneys are also directly involved in the release of three important hormones: erythropoietin (EPO), which stimulates bone marrow to produce red blood cells; renin, which regulates blood pressure; and calcitriol, the active form of vitamin D that maintains calcium for bones and chemical balance within the body.

Most kidney diseases damage the nephrons and cause them to lose their filtering capacity. Diabetes is the most common cause of kidney failure and high blood pressure is a major factor in those with diabetes developing kidney problems. Even without diabetes, high blood pressure ranks as a leading cause of kidney disease, as it damages the small blood vessels and reduces the kidneys’ filtering capacity. If wastes are not being removed and proteins are not being returned to the blood, renal failure and a range of life-threatening health issues requiring medical intervention will ultimately ensue.

Traditional Chinese Medicine (TCM)

The TCM view of kidney function, by contrast, is more comprehensive and holistic, involving more than a discrete consideration of the organs.

TCM is a system of healthcare encompassing acupuncture, herbal medicine, anmo tuina (remedial massage), qi gong (exercise and breathing), diet and lifestyle. TCM has mapped an intricate series of pathways in the body called meridians, which carry our life energy, or qi, back and forth throughout the body. Disease and illness are seen as imbalances or blockages of qi.

TCM recognises that stimulating the points along these meridians by inserting very fine needles and/or applying electrical pulses can restore balance to the flow of qi to the corresponding areas in the body. Massage through acupressure can sometimes achieve similar results. Qi gong is the use of focused awareness, movement and relaxation combined with breathing techniques to enhance the flow of qi through the body.

TCM’s rich diagnostic approach involves detailed questioning on lifestyle and medical history along with comprehensive physical observation, including taking 12 pulses. Unlike Western medicine, which only pays attention to the pulse of the heartbeat, TCM monitors six pulses in each wrist that connect with 12 different organ systems. This contrasts with the usual approach of allopathic [conventional] medicine, which doesn’t normally arrive at a diagnosis until symptoms are so pronounced they are recognised by the sufferer.

Early diagnosis with TCM

TCM assigns the kidneys the foundation position among the other organs as the home of “ancestral qi” and the root of yin and yang for the entire body. The kidneys store the vital life essence, which is produced by qi. According to TCM, we have postnatal qi and prenatal qi. The former is derived from the food and water we consume and the air we breathe; the latter is the qi we’re born with, perhaps similar to our understanding of heredity/genes. In TCM, the kidneys not only encompass renal function but also the influence of the adrenal glands.

In TCM, kidney energy is divided into yin and yang. Kidney yin refers to the nutritive function of the kidneys, body fluids and essential qi. Kidney yang governs the physiological processes of warming and transforming fluids such as hormones. Yin is like the earth or substance that is the body, and yang is the life energy that courses through it.

The TCM view of kidney function is an example of the difference between the Western and TCM frameworks, with the Western medical view considering the body and its functioning but not in any formal sense the life force that courses through it, because it cannot be measured or defined by scientific means.

According to the Western model, early-stage kidney disease is very hard to spot, with few obvious symptoms. Perhaps that’s why most information about nephrology focuses on “worst case” scenarios (that is, those leading to dialysis and kidney transplant). The TCM model, however, allows for earlier detection, and kidney tonics form a great part of TCM herbal remedies.

A deficiency of kidney yin means the body is being run down and is unable to maintain its health, with too much yang energy showing as a flushed complexion, overheating, hypertension, inflammation and so on. Conversely, coldness, a pale complexion, tiredness, low libido and fluid retention are indications of a lack of kidney yang.

In TCM, ageing is seen to be the result of declining kidney energy and usually manifests as low kidney yang. The slowing of our metabolism as we age contributes to many of the low kidney yang symptoms such as coldness, fatigue, emotional withdrawal, mild depression, frequent urination, loose bowels, memory loss and weak back and legs.

Further symptoms of kidney yang deficiency are impotence, sterility, clear urine, dribbling urine, nocturnal emissions, premature ejaculation, oedema of the lower limbs, weak pulse and whitish, moist fur on the tongue — a thoroughly uncharming bunch of symptoms when considered together though one or two of them are probably quite common in middle age.

Kidney tonics to stimulate yang energy by increasing metabolic rate and tightening up organ function can delay the onset of many of these conditions.

Kidney tonics

Morinda (noni)

Morinda officinalis, or noni, has a long history of use in TCM, commonly as a kidney yang tonic using the roots of the plant. Morinda is also known as bajitian. Traditionally recognised for its adaptogenic, aphrodisiac, urogenital astringent, analgesic, hypotensive, digestive stimulant and diuretic properties, it has a tonifying action on the reproductive, urinary, musculoskeletal and central nervous system functions.

The Morinda plant is a genus of around 80 species that mainly grow in tropical regions. There are seven species found in Australia, ranging from three-metre shrubs to 12-metre trees.

Morinda citrifolia(a close relative of Morinda officinalis) has oval-shaped leaves and white flowers that bloom in summer and autumn in Australia and all year round in the more tropical climates of the Pacific Islands. These are followed by the fruit, which are edible and have a pungent aroma. The juice of the fruit is thought to have a wide range of medicinal qualities.

Morinda citrifolia has been used for centuries by Polynesian healers to treat the respiratory, digestive and immune systems. It has a strong healing history in India, South-East Asia and northern Australia. Published information on its use by indigenous Australians indicates that various groups regarded it as an excellent food and a strong medicine.

Morinda citrifoliacontains polysaccharides (including glucuronic acid, galactose, arabinose and rhamnose), coumarin, medium-chain fatty acids, flavone glycosides, sterols (beta-sistosterol), terpenoids, essential oils, amino acids, vitamin C, potassium and limonene, plus morindone (yellow dye), alizarin (red dye), rubiadin and a large range of other anthraquinones in the roots, bark and leaves. The terpenoids help the body detoxify through their antibacterial qualities. The many antioxidants, such as the glycosides, in the noni plant provide defence against free radicals. Scopoletin, or coumarin, has anti-inflammatory properties. Limonene and anthraquinones have antiseptic value in the body.

In recent studies led by Associate Professor David Leach at Southern Cross University in Lismore, the antioxidant activity of noni juice was found to be in a similar range to that of green tea, with its oxygen radical absorbance capacity (ORAC) at a level of 747 to 1517.

Dr M. Wang of the Department of Pathology, UIC College of Medicine, Rockford, Illinois, reported on studies conducted on Tahitian noni juice that showed the superoxide anion radicals scavenging activity of Tahitian noni juice to be 2.8 times that of vitamin C, 1.4 times that of pycnogenol and 1.1 times that of grapeseed powder. Results also revealed that noni juice inhibited cholesterol synthesis.

An antidepressant-like effect was observed in Morinda officinalis in a behavioural swimming test conducted on rats by Z.Q. Zhang and researchers at the Division of Psychopharmacology, Beijing Institute of Pharmacology and Toxicology.

There are also numerous anecdotal reports of noni’s effectiveness in improving vitality, libido, the condition of the skin and hair and many of the symptoms related to low kidney yang levels. It’s particularly useful for people who have a highly sensitive intestinal tract and who suffer frequently from constipation and pain. People who exhibit sluggish metabolism associated with a hypothyroid condition also appear to benefit from noni.

Rehmannia root

Rehmannia root (sheng di huang or shu di huang in Chinese) is another effective ingredient in many kidney tonics. A member of the foxglove family, the root can be used in its raw state as a detoxifying herb that cools the blood in the treatment of wasting fevers. It is cured by soaking and drying the compressed root many times in rice wine, thus warming its influence as a kidney tonic. Like many TCM herbs, it can be used in different preparations as both a yin and yang tonic.

Rehmannia is said to be the “kidneys’ own leading herb”, promoting kidney function, cooling the blood and bringing moisture to dryness. With kidney yin deficiency said to be common today because of our hectic lifestyles, rehmannia root, taken with the supervision of a TCM practitioner, can be of great help in relieving symptoms such as dryness of the scalp and skin, night sweats, frequent urination and dark rings under the eyes.

Lycium

Lycium barbarum, or matrimony vine, is another herb that has been used by the Chinese for thousands of years to improve kidney health. More commonly known as wolfberry fruit and the juice as goji, lycium improves the flow and balance of qi along the kidney, liver and lung meridians. The fruit, in particular, is used and the red berries are said to be sweet and plump. Lycium has been traditionally used to improve vision and prevent headaches resulting from kidney deficiencies. Studies have shown it to be high in antioxidant properties.

Siberian ginseng

Siberian ginseng is a warming TCM kidney yang tonic ingredient. The major chemical components of Siberian ginseng are eleuthrosides A-G (phenylpropanoid, sterol, lignans, isofraxin, carotenoids and coumarins). There is evidence of Siberian ginseng’s cortisol-like anti-inflammatory activity.

Formulas

A traditional vitalising formula for predominantly kidney yin types is what TCM calls an Eight Flavour Tonic. This tonic is designed to re-invigorate the vital fire in those whose essential vitality has waned and who exhibit symptoms like feeling cold all the time, difficulty getting up in the morning, mild depression and generally low energy levels. The major ingredient in this formula is Morinda officinalis (noni) root. Added to this are Asian ginseng, saw palmetto, schisandra fruit, rehmannia root, cistanche sprout, Asian water plantain rhizome, Chinese dodder seed, dong quai root, psoralea seed, Chinese yam root, tree peony root bark, cinnamon bark, cornus berry extract and lycium fruit (goji). This kidney tonic rekindles feelings of warmth and vitality.

The kidney yang type formula is for those with high energy levels and who are prone to exhaustion from excessive work and play. Often these people are also suffering from lack of sleep caused by an overactive mind and poor digestion due to irregular mealtimes. Early symptoms are dryness of the skin, brittle fingernails, dandruff, cracked red tongue, lower back pain, frequent urination and pain in the sole or heel of the foot. These people require a tonic that fosters nourishment and a deep healing energy rather than the stimulating effect of the vitalising formula. This formula is ideal for business people driven to meet deadlines and athletes seeking sustained energy. Ingredients include rehmannia root, poria coco sclerotium, tree peony root bark, Chinese yam root, Asian water plantain rhizome, fo-ti root, chrysanthemum flower, ligustrum seed, saw palmetto berry, lycium fruit extract and cornus berry extract.

While there are many ingredients common to both formulas, the major difference is the presence of Morinda officinalis and Asian ginseng as stimulating, warming agents in the tonic for those who are yang deficient.

Perhaps with the worldwide media attention the 2008 Beijing Olympic Games will attract, there will be a worldwide interest in all things Chinese, including a renewed focus on their wisdom in many things, especially the TCM approach to health and wellbeing. Perhaps as we in the West begin to grasp certain founding principles of TCM, it may indeed give rise to the “time of the kidneys” — their time to be recognised for their profound and vital role as the home of our life force, or qi.