Etiology and Pathogenesis of Kidney Disorders in TCM
Innate insufficiency and congenital deficiency; overwork and excessive sexual activity; excessive childbirth and chronic illness affecting the kidney; and external pathogenic invasion or internal injury to the kidney are all major causes of kidney disorders.
The pathology of kidney disorders primarily stems from inherent kidney deficiency. For example, kidney yang deficiency leads to failure of the "gate" to close properly, impaired qi movement, retention of water and dampness, resulting in edema or fluid retention. If the lower burner is weakened and vital fire of the life gate declines, it may lead to impotence or early morning diarrhea. Kidney qi deficiency impairs containment and retention, causing spermatorrhea, premature ejaculation, or urinary incontinence. Kidney failure to receive qi results in dyspnea and shortness of breath. Kidney yin deficiency fails to nourish wood (liver), leading to vertigo and tinnitus. Depletion of kidney yin prevents it from reaching the heart, causing virtual fire to rise and disrupting heart-kidney harmony, resulting in restlessness, insomnia, palpitations, tidal fever, and night sweats. Kidney yang deficiency impairs qi transformation in the bladder region, leading to urinary retention. External pathogens invading the kidney, such as damp-heat accumulation or blood stasis obstructing collaterals, can also cause edema, urinary tract disorders, and other conditions.
Traditional TCM holds the view that "the kidney has no real syndromes" or "the kidney is mostly deficient." Clinical evidence shows that most kidney disorders stem from kidney deficiency, but real syndromes do exist—such as edema, urinary tract disorders, and back pain caused by wind invading the kidney, damp-heat accumulation, or blood stasis obstructing collaterals—which can be considered real syndromes or syndromes with deficiency and excess.