Renal Function Improvement Following <i>Bojungikgi-tang</i> Treatment in an Elderly Patient with Chronic Kidney Disease Undergoing Hemodialysis: A Case Report

Objectives: Chronic kidney disease (CKD) is common in older adults and is often complicated by anemia requiring blood transfusions, which raises concerns regarding renal safety. Evidence regarding the renal and hepatic safety of Korean herbal medicine, including <i>Bojungikgi-tang</i>, in elderly patients with CKD remains limited.Methods: An 84-year-old woman with CKD and multiple comorbidities, including type 2 diabetes mellitus, hypertension, dyslipidemia, asthma-chronic obstructive pulmonary disease overlap syndrome, hypothyroidism, internal carotid artery stenosis, viral pneumonia, urinary tract infection with urosepsis, and renal stones, presented with nausea, vomiting, dyspnea, generalized weakness, and motor weakness.During a 72-day hospitalization, the patient received integrative treatment consisting of Korean medicine therapies, including the herbal formula <i>Bojungikgi-tang</i>, acupuncture, electroacupuncture, moxibustion, dry cupping, and infrared therapy, in combination with conventional Western medical treatment and weekly blood transfusions. Clinical changes were evaluated using serial renal and liver function tests, as well as inflammatory markers. Blood samples were collected immediately before each transfusion at a consistent time of day.Results: During hospitalization, renal function parameters indicated an improvement in CKD stage from 5 to 4, while liver function tests remained stable throughout the treatment period. The patient’s supplemental oxygen requirement decreased progressively from 2.0 L/min to 0.5 L/min. Vancomycin-resistant Enterococcus detected at admission became undetectable for three consecutive weeks, allowing discontinuation of isolation measures. No treatment-related adverse events were identified.Conclusion: This case suggests that Korean medicine-based integrative treatment may be associated with symptomatic relief and improved quality of life in patients with CKD receiving blood transfusions. However, well-designed controlled studies are required to determine the independent effects and safety profile of modified <i>Bojungikgi-tang</i> in the management of CKD.