Potential benefits of complementary medicine modalities in patients with chronic kidney disease.

Use of complementary and alternative medicine (CAM) by the general population is common, and, although potential for harm exists, evidence is accumulating that several modalities, including acupuncture, massage, relaxation response/guided or integrative imagery, meditation, and herbal supplements, have actions that are beneficial for patients with chronic illness. Potential areas in which CAM might benefit patients with kidney disease include prolonging time of progression to kidney failure as well as treatment of concomitant problems, including arthritides, pruritus, cardiovascular risk factors, anxiety, depression, and fatigue, as well as hepatoprotection and treatment of uremic bruising. Although no systematic survey of prevalence of use has been performed in patients with chronic kidney disease and much research remains to be done so that safety and efficacy issues can be resolved, it is likely that many patients are using the services of CAM providers without the knowledge of their nephrologists. Thus, it behooves us to become conversant in these therapies so that we may hold open dialogues with our patients, discouraging potentially harmful treatments, suggesting potentially helpful ones, and monitoring them for effects, both beneficial and harmful.