Summary of case history

　Patient ZHOU

male

50 years old

was hospitalized in a local hospital more than 6 years ago due to fatigue and diagnosed with hypokalemia

but the specific diagnosis and treatment were unknown. After discharge

the patient received long-term oral potassium chloride sustained-release tablets for potassium supplementation

but the serum potassium was not regularly monitored. More than 1 year ago

the renal insufficiency was found in the physical examination of other hospitals (Scr 176 μmol/L

no laboratory test sheet)

and the patient did not pay attention to treatment. 2 months ago

the patient was hospitalized in

Department of Nephrology

The Second Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine

for recurrence of fatigue. Relevant examinations were completed during hospitalization

the patient was diagnosed with chronic kidney disease stage 3

medullary sponge kidney

type I renal tubular acidosis

hyperuricemia

etc. Potassium citrate granules were given to correct low potassium and acidosis

feburestat inhibited the production of uric acid

and chinese herbs were used to strengthen the kidney and spleen

remove blood stasis and relieve turbidity. He was discharged from the hospital with improved symptoms

and kept taking potassium citrate granules after discharge. 1 week ago

the patient's fatigue occurred again

Then he consulted the nephrology clinic of

Department of Nephrology

The Second Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine

. At present

the patient has fatigue

soreness of waist

poor appetite

foamy

urine

nocturnal urine 2~3 times

no gross hematuria

no edema

and fearless cold

poor sleep

constipation

blood pressure: 119/86 mmHg. Four diagnostic information: fatigue

pale. dark-red tongue

side tooth marks

yellow and greasy tongue coating in root of tongue

pulse sinking slippery.

TCM diagnosis

　Chronic renal failure

kidney accumulation disease (spleen and kidney qi deficiency

dampness-heat and stasis.

Western medicine diagnosis

　1.Chronic kidney disease stage 3; 2.Medullary sponge kidney; 3.Type I renal tubular acidosis; 4.Hyperuricemia; 5.Hypertension.

Therapeutic methods

　Chinese herbs to strengthen the kidney and spleen

eliminate turbidity and remove stasis

plus diuresis to remove stone. And western medicine was given potassium citrate granules 4 g twice a day to replenish potassium and correct acidosis; Febuxostat 20 mg 1 time per day was given to reduce uric acid.

Clinical outcomes

　After 7 months of treatment

the symptoms were relieved

and the renal function was significantly improved. It is suggested that Yishen-Jiangzhuo method is effective in treating chronic kidney disease stage 3 with medullary sponge kidney complicated with tubular acidosis type I.