Lei Piao,1 Jian Ma,2 Na Zhao,2 Yongqing Hou,1 Tehasi Wang1 

1The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, People’s Republic of China; 2Endocrinology Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, People’s Republic of China

Correspondence: Jian Ma, Endocrinology Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, People’s Republic of China, Email MJ196153@163.com

Abstract: Diabetic kidney disease (DKD) is the predominant etiology of end-stage renal disease (ESRD). Despite rigorous therapeutic interventions aimed at managing hyperglycemia, regulating blood pressure, and employing renin-angiotensin system inhibitors, the incidence of DKD remains high. Recent investigations have indicated a shift in the disease spectrum of DKD accompanied by significant advancements in the development of novel therapeutic options. Nevertheless, in addition to agents such as renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and mineralocorticoid receptor antagonists (MRA), there is currently no optimal strategy in contemporary medicine to effectively mitigate the progression of DKD. The application of TCM in the management of DKD has demonstrated its potential in delaying disease progression and enhancing patient quality of life, thereby playing a crucial role in the prevention and treatment of this condition. Clinical evidence supports its efficacy and safety profile. This article aimed to explore the TCM approach to DKD, focusing on aspects such as etiology, pathogenesis, syndrome differentiation, and comprehensive treatment, while also analyzing the latest research developments in the pathophysiology of DKD.

Keywords: DKD, ERSD, pathophysiology, TCM