People on dialysis need to be extra cautious with herbal medicine. Below is a clear, patient-friendly explanation for a Western audience, plus safer Traditional Chinese Medicine (TCM)-style supportive options that don't involve taking herbs by mouth.

 

Part 1. How Kidney Function Changes in Dialysis Patients

Severe structural kidney damage
In most dialysis patients, much of the kidney's filtering structure is permanently damaged. The glomeruli largely lose normal filtration ability.

Greatly reduced clearance and altered metabolism
Advanced kidney failure disrupts the body's metabolic balance and can significantly change how substances are absorbed, distributed, and cleared-including herbs and supplements.

Part 2. Potential Risks of Herbal Medicine in Dialysis

1) Added burden on the liver and kidneys

Many herbal constituents are processed by the liver and/or eliminated through the kidneys. In people with organ failure, this can increase the risk of serious complications (for example, worsening kidney injury or liver toxicity).

2) Electrolyte disturbances

Dialysis patients are especially vulnerable to dangerous shifts in minerals and fluids.

High potassium risk (hyperkalemia): Some herbs can be high in potassium or affect potassium balance, which may trigger abnormal heart rhythms and, in severe cases, cardiac arrest.

Heavy metal contamination/toxicity: Some traditional preparations may contain or be contaminated with heavy metals. This is particularly risky for dialysis patients.

3) Drug interactions (very common)

Herbs can change how prescription medications work-either strengthening effects (raising side‑effect risk) or weakening effects (reducing benefit).

Cistanche and Danshen (Salvia miltiorrhiza) may increase bleeding risk when combined with anticoagulants/antiplatelet drugs (common in dialysis care).

 

 

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Combining herbs with immunosuppressants (e.g., after transplant or in certain kidney diseases) may alter drug levels or effects.

Important: If you have severe swelling (fluid overload), high potassium, heart failure, or severe anemia, taking herbs without close medical supervision may worsen your condition.

 

Part 3. Safer TCM-Inspired Supportive Options (Non‑Oral)

These approaches may be used as comfort/supportive care alongside dialysis-ideally after checking with your dialysis team (especially if you bruise easily, have neuropathy, fragile skin, or a fistula/graft).

A) Moxibustion (heat therapy with mugwort)

CV4 (Guanyuan), ~3 cun below the navel
Ginger-separated moxibustion, 3 times/week, about 5 small rounds per session.
Traditional goal: warm/support "kidney yang," help cold intolerance and frequent nighttime urination.

ST36 (Zusanli), ~3 cun below the outer knee
10 minutes daily.
Traditional goal: support digestion/energy, help poor appetite and fatigue.

PC6 (Neiguan), ~2 cun above the inner wrist crease
When nausea occurs during dialysis: press and hold while slow breathing.
Traditional goal: calm the body and ease nausea/anxiety.

B) Acupressure / gentle massage

KI3 (Taixi), between the inner ankle and Achilles tendon
Twice daily, about 3 minutes each time.
Traditional goal: support "kidney yin," help dry mouth and night sweats.

BL23 (Shenshu), 1.5 cun lateral to the L2 spine level
Light tapping in the morning.
Traditional goal: improve low back/knee weakness and promote circulation.

C) Gua sha & cupping (use with caution)

Gua sha: gentle strokes along the midline back channel and bladder lines may help fatigue and a heavy, swollen feeling.

Cupping: can be used away from fragile skin; avoid areas with ulcers, infection, severe edema, or easy bruising.

 

Friendly Reminder

If you want to use TCM or herbal products while on dialysis, do it only under supervision from a qualified clinician (TCM practitioner and your nephrology/dialysis team). Always share a full list of all prescriptions, OTC medications, and supplements. Do not self-medicate with herbs-the risks can be serious.