A Case of Chronic Kidney Disease Stage G4 with Improved Renal Function Following Integrative Korean and Western Medicine Treatment

Background: Chronic kidney disease is generally considered irreversibly progressive, and regression from stage G4 is rarely documented in pre-dialysis patients.Case presentation: A 67-year-old woman had remained within CKD stage G4 for 14 months under conventional care, with an estimated glomerular filtration rate (eGFR) of 21.1-28.4 mL/min/1.73 m². Over the following 12.7 months, she received integrative Korean and Western medicine treatment consisting of acupuncture and moxibustion (90 sessions), <i>Jowiseungcheong-tang-gami</i> [a modified <i>Jowiseungcheong-tang</i>] taken intermittently for a total of 67 days, and lifestyle modification, while Western medications, including olmesartan, were tapered or discontinued. During treatment, eGFR reached the G3b range at four of six measurements (up to 32.3 mL/min/1.73 m²), with a transient return to G4 in between. Body weight fell by 11 kg, and HbA1c improved from 6.3% at baseline to 5.6-5.9% thereafter (5.9% at the final measurement). No adverse events were observed.Conclusion and discussion: eGFR repeatedly reached the G3b range during treatment, and four of five measurements from 4 months onward exceeded the pretreatment maximum. As multiple interventions were used concurrently, the contributions of the individual components could not be separated; controlled studies are warranted.