Important Guidelines For Kidney Disease in 2023

1. Guidelines for early evaluation and management of chronic kidney disease in China

It is estimated that there are 132 million patients with chronic kidney disease (CKD) in China, of which 84.3% are in the early stages of CKD stage 1-2 and 14.8% are in stage 3 of CKD. However, the awareness rate and diagnosis rate of CKD in China are low. This reality requires the introduction of an early management guideline for CKD that is more in line with national conditions and practice.

Click to Cistanche for kidney disease

The Kidney Disease Prevention and Control Professional Committee of the Chinese Society of Preventive Medicine officially launched Chinese guidelines for high-quality early evaluation of CKD in August this year. This guideline aims to improve the understanding of CKD, improve the evaluation of early CKD, promote the rational diagnosis, treatment, and standardized management of early CKD, and ultimately improve the health outcomes of CKD patients.

Compared with the 2022 version of the guideline, the highlights of the 2023 version of the guideline mainly focus on medication for high-risk groups of CKD, blood pressure management goals for CKD patients, medication for people with CKD combined with heart failure, application of new drugs in the CKD population, and CKD education. The two guidelines are basically consistent in terms of screening population and frequency, CKD diagnostic criteria, and the importance of actively controlling proteinuria.

2. 2023 KDIGO Clinical Practice Guidelines for the Management of Glomerular Diseases

Over the past 10 years, there has been an increasing understanding of the molecular basis of glomerular diseases and the differences between the different categories, as well as novel immunosuppressive therapies and other therapies (such as SGLT2i).

In terms of consensus, the "2021 KDIGO Clinical Practice Guidelines for the Management of Glomerular Disease" (hereinafter referred to as the Guidelines) is the first substantial update of the KDIGO (Kidney Disease Improving Global Outcomes Organization) since it released the Guidelines for the Management of Glomerular Disease in 2012.

With the continuous development of society, after the 2021 KDIGO guideline update, the academic community also has some new views on the management of glomerular diseases.

The KDOQI (National Kidney Foundation Kidney Disease Outcomes Quality Initiative) working group (hereinafter referred to as the expert group) reviewed and supplemented the 2021 guidelines article by article, aiming to better help clinicians diagnose and treat glomerular diseases. This article focuses on the general management principles of glomerular diseases, which mainly include the following three aspects: indicators for screening and diagnosis of glomerular diseases, management of glomerular disease complications, and efficacy evaluation.

For more details, recommended reading: Follow KDOQI experts to learn the glomerular disease management guidelines. Pay attention to these 3 key points!

3. China's first clinical practice guideline for acute kidney injury

Among kidney diseases, acute kidney injury (AKI) is a common and critical condition with a high risk of death. The etiological mechanisms of AKI are complex and the harm is huge. Even though academic organizations such as the Kidney Disease Improving Global Outcomes Organization (KDIGO) have already launched AKI-related guidelines, they are still somewhat different from the practice in China.

Therefore, the National Chronic Kidney Disease Clinical Research Center, the Nephrology Physician Branch of the Chinese Medical Doctor Association, and the China Acute Kidney Injury Clinical Practice Guidelines Expert Group launched the "Chinese Acute Kidney Injury Clinical Practice Guidelines" this year, proposing localization for the clinical practice of AKI in China. Authoritative guidance.

4. China's first clinical practice guideline for the diagnosis and treatment of cardiorenal syndrome (2023 edition)

Cardiorenal syndrome (CRS) is caused by heart or kidney disease, in which acute or chronic dysfunction of one organ triggers acute or chronic dysfunction of another organ. CRS is a functional diagnosis of the heart and kidneys, not a disease diagnosis, and a variety of heart or kidney diseases can cause CRS.

However, there are still problems in the clinical diagnosis and treatment of CRS in China, such as insufficient awareness among clinicians, low CRS diagnosis rate, non-standard CRS treatment, and few localized CRS clinical studies.

In December, the "Clinical Practice Guidelines for the Diagnosis and Treatment of Cardiorenal Syndrome (2023 Edition)" jointly formulated by Chinese multidisciplinary experts was finally officially launched.

In clinical practice, heart or kidney failure is not a rare condition. The significance of this guideline is to clarify the understanding of CRS, that is, heart/renal failure can affect each other.

There is still room for further development of clinical evidence for CRS, and many suggestions and recommendations in this guideline are based on clinical trial evidence of heart failure and/or CKD. In the future, breakthroughs are expected to be made in these key scientific issues.

The guideline emphasizes the importance of early identification of CRS, clarifies that the volume, inflammation, complications and prognosis of CRS need to be assessed before treatment, and finally clarifies the way forward for the diagnosis and treatment of CRS.

How Does Cistanche Treat Kidney Disease?

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.