Angry Doctor

Friday, November 24, 2006

How NOT to argue for Alternative Medicine 5

angry doc grows weary, but he feels he cannot let this article on Today today go unchallenged...

The Solution lies with you
Richard Seah

THE kidney has become like a computer. When it stops functioning, it makes more sense to get a replacement than to keep servicing the old one.

And so we are now recommending that people suffering from advanced stage of kidney failure should opt for a transplant, instead of dialysis, as the treatment of choice.

It does make sense. A transplant is a one-off event. In the long-term, it costs less money than regular dialysis. It is also more productive than lying down doing nothing while receiving dialysis.

An organ transplant, however, is not without its risks — including those associated with major surgery, organ rejection and side effects of anti-rejection drugs. Several anti-rejection drugs can actually cause decreased kidney function.

So even if kidney transplant is preferable to dialysis, it is, at best, the lesser of two evils — still far from the ideal.

We need to look into the broader, longer-term issue of prevention. Or the problem of kidney failure will just get bigger. Already, Singapore has one of the highest rates of kidney failure in the world. Do we want to be No 1?

A quick check at the National Kidney Foundation (NKF) and Health Promotion Board websites did not turn up any advice on how kidney disease might be prevented.

The NKF mentions that it launched a "massive prevention programme" in 1997 but this consists primarily of health screening. Screening is detection, not prevention.

At best, screening can lead to early treatment to prevent the disease from worsening. True prevention means not having the disease arise in the first place.

Medically, it is known that kidney patients can slow down the worsening of the disease by limiting their intake of protein (meat), phosphorus (soft drinks, milk, dairy products and dried beans) and sodium (salt). It is also known that many types of chemical toxins and pharmaceutical drugs can cause kidney failure.

Does it not follow that normal, healthy people can slow down, or even avoid, the development of kidney disease by limiting their consumption of the same substances?

While our public health education programmes does recommend limiting salt intake, little is said about the rest. Our health education programmes also do not state clearly the link between meat, dairy, soft drinks, etc and kidney disease. Instead, these programmes tend to focus on the heart.

Traditional Chinese Medicine has plenty to say about how to care for the kidneys — because the kidneys (along with the adrenal glands and reproductive organs) are regarded as being responsible for a person's overall vitality.

And so there are plenty of herbs, tonic foods, exercises, massage techniques (such as foot reflexology) for keeping the kidneys in good shape.

These may not be scientific. But that is because the pharmaceutical and medical industries have little interest in studying things that lack the potential to generate huge profits.

Any research into traditional methods for preventing — and possibly reversing — kidney failure will therefore have to be initiated and funded by governments, universities and public organisations like the NKF.

Being in Singapore, with excellent medical and scientific facilities as well as access to traditional medical knowledge, places us in a prime position to conduct research of this nature. So will someone please take up the challenge?

For those who cannot afford to wait for scientific research that might never take place, try using a ginger compress: Dip a towel into some hot water with grated ginger mixed in, then squeeze it until it's nearly dry. Fold and place the compress over the kidneys on your upper back, and cover it with another dry towel to keep the heat in. Repeat for about 20 minutes until the area is red.

This treatment draws blood to the kidneys to heal it. It is a simple yet powerful treatment used by kidney patients I know.

If you can restore and retain your original kidneys, that would be the ideal. Kidneys are not computers. New ones are not necessarily better.

For the most part what Mr Seah wrote makes sense. Singapore does have a high incidence of renal failure that warrants our attention, and prevention is better than cure.

But unfortunately Mr Seah utilised the same old flawed arguments and fear to advocate the use of unproven therapy.

The fact is traditional Chinese medicine (TCM) is big business, and TCM remedies for renal diseases have been and are being studied, and there is evidence that some of them may slow down the progression of renal failure.

See for example this 'local' article, or do a pubmed search to see more. Hardly something that 'might never take place', don't you think?

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  • The modification of diet in renal disease (MDRD) study failed to find evidence that dietary therapies could significantly alter the course of kidney disease. Why do physicians, who are supposedly trained in science, continue to cite as facts notions that are not supported by empirical research? In my opinion, such behavior is no more scientific than that of those who glorify alternative medicine.

    By Anonymous Anonymous, At November 25, 2006 8:21 am  

  • Hi angry doc, when I read that article by Richard, I had a strong feeling you would write something about it :)

    As it is, the majority of renal failure cases are attributed to complications from Diabetes Mellitus.

    So this whole "dietary modification/low protein/low salt" approach doesn't really make that much of a difference to the overall renal failure numbers.

    And as wbmccarty has pointed out, there has been no conclusive evidence to show that a high protein diet INCREASES renal failure rates among normal people no other co-morbidities.

    Richards Seah has his own preferences and biases when it comes to healthcare and sickcare. I am quite familiar with the people on both extremeties having worked on both ends of the spectrum. The ones who say nutrition and alternative medicine is the best solution for everything, and the ones who say that western evidenced based medicine is the only thing worth talking about.

    Both are as right as they are wrong.

    Both also tend to have a lot of knowledge about one end of the spectrum but little knowledge of the other end. Hence a skewed perception.

    Having learned what I learned in my TCM course as well as medical school. I would say that the "ginger" treatment has its foundations in TCM and there are TCM explanations on how it works. (I won't go into details about it here)

    However, I doubt any good TCM physician here in Singapore would be medico-legally correct to tell their patients to forgo dialysis with just using this treatment.

    The idea is this. Why can't western medicine and TCM be used together, as long as neither causes more harm than good to the patient?

    I think it is important that at least some of us doctors (western and TCM alike and alternative medicine practitioners) learn more about each other's fields and walk on the middle ground rather than espound such blatantly extremist views.

    It helps nobody, angers people and confuses patients.

    By Blogger Dr Oz bloke, At November 25, 2006 9:39 am  

  • And when I wrote this post, I had a feeling you would be commenting on it. :)

    The way I see it, western medicine is already on the middle ground, and that middle ground is science.

    Western medicine shows that it is willing to examine remedies and accept the proven ones, regardless of where they might have originated. There are the examples of the Chinese herbs mentioned in this post, and of course fish oil.

    (And we both know that if the 'ginger compress' is proven to be effective, some drug company will patent the active ingredient and come with with some expensive medicated patches...)

    Unfortunately some sectors of the alternative medicine community continue to argue that their discipline should not be subjected to the same scientific scrutiny (as I have illustrated on several occasions).

    By Blogger angry doc, At November 25, 2006 11:51 am  

  • For those who wish to read more about the role of dietary protein restriction in patients with chronic renal disease, there are two review articles (one for and one against) available here (scroll down):

    By Blogger angry doc, At November 25, 2006 12:57 pm  

  • Please note that my previous comment pertained quite specifically to the role of diet in altering the course or rate of progression of chronic kidney disease, which has not been adequately demonstrated in experimental studies. Even the article in favor of low-protein diets concedes this point, writing that the "role of dietary protein restriction in the progression of CKD has not been proven." Like the author of that article, I concede that protein restriction may be of value for other reasons, such as reduction of uremia and uremic symptoms.

    I did not intend to comment on the potential risks to healthy patients of a high-protein diet. I don't recall any studies that demonstrate that such diets are hazardous to patients other than those having CKD. But, about 1 in 9 US persons have CKD and about 75% of them are unaware of their disease. So, I suggest that high-protein diets may be risky to the general population, among whom there are many persons who have CKD but do not realize it.

    By Anonymous Anonymous, At November 25, 2006 2:07 pm  

  • This comment has been removed by a blog administrator.

    By Anonymous Anonymous, At November 26, 2006 11:37 pm  

  • Hi anonymous,

    I have written a post regarding your experienced at my blog :

    Please have a read.

    By Blogger Dr Oz bloke, At November 27, 2006 11:10 am  

  • Anon,

    If you have a legitimate complaint, I would advise you go through the proper channels to have it addressed and not post an anonymous comment on a public domain site.

    Thank you.

    By Blogger angry doc, At November 27, 2006 5:00 pm  

  • This very interesting subject!! Thank you!!

    By Anonymous Anonymous, At May 12, 2010 1:51 am  

  • Way to go Doc!
    You are a informative doctor who dare to challenge and tell the TRUTH!

    Shui gui cao(水龟草),ginger and red dates can do wonders for kidney patients.

    More info in my Natural cancer Blog.

    By Blogger Phantom, At September 13, 2012 12:52 am  

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    By Anonymous Anonymous, At December 30, 2012 11:16 pm  

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