Nephrology

The Department of Nephrology of Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine was established in the 1950s and is one of the earliest specialized departments of traditional Chinese medicine nephrology established nationwide. The Department has a long history of using traditional Chinese medicine and integrated traditional Chinese and Western medicine to treat kidney diseases. Beginning in the 1950s, under the guidance of renowned traditional Chinese medicine scholars and nephrology experts, Professors Tong Shaobo, Yu Zhiding, Zhong Nianwen, Zheng Pingdong and others, it brought the distinctive features of traditional Chinese medicine into play, highlighted its advantages, and proposed treatment formulas and medicines such as supporting healthy qi and discharging turbidity, and dispelling wind and overcoming dampness, achieving good clinical efficacy. Through extensive clinical and experimental research, it summarized the patterns of treatment based on syndrome differentiation and accumulated rich experience. In the 1960s, the academic papers published by the Department on treatment based on syndrome differentiation of chronic nephritis and on treating chronic nephritis by strengthening the spleen and tonifying the kidney had a major influence and remain widely used in clinical practice. Beginning in the 1970s, the Department conducted research on traditional Chinese medicine treatment of recurrent and refractory nephrotic syndrome, as well as clinical and experimental research on chronic renal failure, and began hemodialysis using an artificial kidney. In the 1980s, it created an animal model of chronic renal failure induced by adenine and conducted research on using traditional Chinese medicine to treat the retention of the uremic toxins methylguanidine and guanidinosuccinic acid in chronic renal failure. In the mid-1980s, it pioneered the use of low-dose hormones combined with traditional Chinese medicine treatment based on syndrome differentiation for refractory and recurrent nephrotic syndrome. From the 1990s into this century, it kept pace with the international cutting edge of nephrology research and further studied, at the cellular and molecular levels, the mechanisms by which traditional Chinese medicine improves renal fibrosis in chronic renal failure. From the perspectives of renal hemodynamics, cellular immunomolecular science, renal oxygen consumption and energy metabolism, and renal histopathology, it conducted clinical observation and experimental research on Renal Failure Granules, Niaoduning Granules and Kangxianling Granules for treating early- and mid-stage chronic renal failure, as well as on Guben Tongluo Granules for treating IgA nephropathy. Research on the efficacy and mechanisms of integrated traditional Chinese and Western medicine, mainly using the methods of strengthening the spleen and tonifying the kidney, activating blood and removing stasis, and clearing heat and detoxifying, for chronic renal tubulointerstitial lesions has also been at the forefront of research in China. In 2004, the Institute of Traditional Chinese Medicine Nephrology of Shanghai University of Traditional Chinese Medicine was established. It is an innovative clinical treatment and research collective integrating clinical care, teaching and scientific research, with the department and institute functioning as one. It is now a National Clinical Key Specialty; one of the main core members of the Ministry of Education National Key Discipline of Higher Education Institutions—Traditional Chinese Medicine Internal Medicine, the Ministry of Education Key Laboratory of Liver and Kidney Disease Syndromes at Shanghai University of Traditional Chinese Medicine, and the Shanghai Key Laboratory of Traditional Chinese Medicine Clinical Medicine; a key discipline and key specialty of the National Administration of Traditional Chinese Medicine; a key discipline of Shanghai Municipality; the lead unit of the Shanghai Municipal Education Commission Nephrology Innovation Team; the Zheng Pingdong Academic Experience Research Studio of Famous Traditional Chinese Medicine Physicians in Shanghai; the He Liqun Studio of a Famous Traditional Chinese Medicine Physician in Shanghai; the Tong Shaobo Research Studio of a Famous Senior Traditional Chinese Medicine Physician of the Shanghai School; an Advanced Collective in the Shanghai Municipal Health System; and the Nephrology Advantageous Discipline and Traditional Chinese Medicine Special Disease Specialty of the Shanghai Municipal Health Bureau. It has successively led and undertaken more than 100 projects, including 12 National Natural Science Foundation of China projects, the National Science and Technology Support Program of the 11th Five-Year Plan, a special project for the traditional Chinese medicine industry of the Ministry of Science and Technology, the Special Fund for Doctoral Discipline Sites of the Ministry of Education, the Shanghai Natural Science Foundation, key research projects of the Shanghai Municipal Commission of Science and Technology, and the Key Discipline Group Construction Fund of Pudong New Area, with total research funding exceeding 40 million yuan. The Department makes full use of the advantages of integrated traditional Chinese and Western medicine and, focusing on its main research directions, conducts clinical mechanism research on traditional Chinese medicine and integrated traditional Chinese and Western medicine. The distinctive features and main areas of focus of the Department are traditional Chinese medicine and integrated traditional Chinese and Western medicine treatment of chronic renal failure, IgA nephropathy, chronic urinary tract infection, chronic renal tubulointerstitial disease, diabetic nephropathy, chronic nephritis and other conditions. It has developed a series of in-house hospital preparations, including Yishen Zhishuai Granules, also known as Shenshuai Granules, for treating chronic renal failure; Huangqi Xiaobai Granules and Huangqi Capsules for proteinuria caused by chronic nephritis; and Xueniaoling Granules for hematuria caused by chronic nephritis. It has also developed distinctive and effective formulas and medicines, including Guben Tongluo Formula for IgA nephropathy, Wuzi Yishen Oral Liquid for frequent urination due to kidney deficiency, Huayu Paishi Decoction for urinary tract stones, and a uric-acid-lowering formula for hyperuricemic nephropathy.

In 2017, the hospital recruited professors and chief physicians from the Department of Nephrology of the former Second Military Medical University-affiliated Changzheng Hospital and the PLA Institute of Nephrology. This expanded the concepts of Western medical treatment and the advanced technologies used in Western medicine for kidney diseases. Various immunosuppressants, particularly calcineurin inhibitors, are rationally used to treat various refractory nephrotic syndromes, while combined traditional Chinese medicine treatment reduces drug-related adverse effects. The Department further developed its existing blood purification technologies, including modified plasma exchange, saving patients with severe pulmonary hemorrhage–rapidly progressive renal failure syndrome and other conditions. It expanded the scale of the blood purification center; in particular, it developed various vascular access techniques, solved difficult vascular access problems and managed complications, conducted clinical research on vascular access, and vigorously promoted the clinical application of continuous renal replacement therapy (CRRT), increasing the chances of rescuing patients with various acute and chronic multiple-organ dysfunctions.

The research achievements of the Department of Nephrology of Shuguang Hospital have received more than 20 science and technology progress awards at various levels and of various types, and 10 patents have been authorized. More than 600 academic papers have been published in China and abroad, including more than 50 SCI papers, and more than 20 monographs have been published. The Department has successively sent 10 personnel to the United States, Japan and France to conduct experimental molecular biological research on chronic renal failure, chronic nephritis, chronic renal tubulointerstitial lesions and polycystic kidney disease. The results have been published in authoritative international nephrology journals, including JASN, Kideny Int., Nephron, JCI, Clinical Nephroloy, Nephrology, PLos One, World J of Urology and Renal Failure. It is at the forefront of clinical research on traditional Chinese medicine nephrology in China.

To promote discipline development and operational growth, the Department of Nephrology of Shuguang Hospital highlights the complementary and organic integration of the inheritance of its traditions and modern innovation. With the improvement of clinical efficacy as its objective and academic experience studios of famous senior traditional Chinese medicine physicians as its platform, it further inherits and develops the academic thought and clinical experience of renowned senior traditional Chinese medicine physicians, continuously improves the levels of traditional Chinese medicine and integrated traditional Chinese and Western medicine diagnosis and treatment, establishes the distinctive advantages of diagnosing and treating nephropathy based on traditional Chinese medicine principles, and develops distinctive brands. It is also developing distinctive capabilities in the establishment and maintenance of vascular access for blood purification, complication management, vascular access nursing, patient management and vascular access team building. The goal is to build the Department into an advantageous discipline with stronger technical capabilities, significant clinical efficacy, larger facilities and scale, and broader social influence, attracting patients with chronic kidney disease from throughout the country, especially patients from East China, who come for treatment because of its reputation. It also attracts physicians at all levels from throughout the country for further training. The Department has strong resources in clinical care, teaching and research, a well-structured academic echelon, 107 inpatient beds, and 57 hemodialysis beds, with expansion already under way to 82 stations. During the past three years, it has discharged more than 4,316 patients annually; it has had more than 148,000 outpatient visits annually and more than 35,000 hemodialysis visits annually. It has established a diversified range of clinical diagnosis and treatment technologies in traditional Chinese and Western medicine, including routine renal biopsy, creation of various vascular accesses, complication management, peritoneal dialysis, traditional Chinese medicine colon dialysis, traditional Chinese medicine iontophoresis, plasma exchange and CRRT, with significant clinical efficacy.

The Department currently has 24 core professional staff members: 8 with senior professional titles, 8 with associate senior titles, 6 with intermediate titles and 2 with junior titles. Fourteen hold doctoral degrees and 10 hold master’s degrees; there are 3 doctoral supervisors and 10 master’s supervisors; 2 Famous Traditional Chinese Medicine Physicians of Shanghai, 2 Famous Traditional Chinese Medicine Physicians of Shuguang Hospital, 1 Shanghai Leading Talent, 1 Shanghai Medical Leading Talent, 1 Shanghai Outstanding Academic Leader, 1 National Outstanding Traditional Chinese Medicine Clinical Talent, 2 inheritors of the academic experience of veteran traditional Chinese medicine experts from the fifth national cohort, and 1 Xinglin Scholar.

The Department is a base for clinical teaching, clinical internships and clinical practicums of the Shuguang Clinical Medical College of Shanghai University of Traditional Chinese Medicine, as well as a standardized training base for residents in Shanghai. It undertakes teaching in Chinese and English for the undergraduate, seven-year, graduate, international student and adult education programs of Shanghai University of Traditional Chinese Medicine, covering Basic Diagnostics, Internal Medicine of Traditional Chinese Medicine, Internal Medicine of Western Medicine, and Clinical Progress in Traditional Chinese Medicine Nephrology, as well as clinical practicums, internships and the supervision of physicians in standardized training. Many members of the Department have considerable academic influence in Shanghai and even nationwide.