March 2023: By Editorial Staff at Acupuncture Today

A pair of new studies suggest acupuncture can help manage common complications experienced by renal disease patients on hemodialysis: muscle wasting and uremic pruritis.

Acupuncture for Muscle Wasting

The study on muscle wasting, published in the Shanghai Journal of Acupuncture and Moxibustion, compared two groups of dialysis patients, with one group receiving standard intervention (physical therapy sessions, including progressive resistance training, and guided nutrition) and the other receiving warm-needle acupuncture in addition to the standard intervention.

Acupuncture patients received five weekly sessions of acupuncture at LI-15 (Jianyu), LI-11 (Quchi), LI-4 (Hegu), ST-36 (Zusanli), SP-6 (Sanyinjiao), and KD-3 (Taixi). Needles were warmed by attaching a 15 mm moxa piece to the end of each needle.

Both groups were assessed at baseline and after the 16-week treatment intervention, comparing gains in muscle mass and function per several variables.

Patients in the acupuncture group displayed superior improvements in muscle strength / function variables compared to non-acupuncture patients, including Appendicular Skeletal Muscle Mass Index (ASMI: the sum of the lean muscle mass of the upper and lower extremities adjusted with height), grip strength, and gait velocity.

The research team also evaluated levels of serum irisin (a hormone secreted in muscle during exercise) and TNF-a (a pro-inflammatory cytokine) before and after the 16-week intervention. While between-group levels were equivalent at baseline, levels of serum irisin increased significantly in the acupuncture group, while TNF-a levels dropped significantly. By comparison, serum irisin rose only slightly in the non-acupuncture group, and TNF-a levels remained the same.

Acupuncture for Uremic Pruritis

In the study on uremic pruritis, published in the Journal of Pain and Symptom Management, researchers performed a systematic review, ultimately yielding seven randomized, controlled trials for meta-analysis. In all seven studies, "acupuncture was the main treatment, either alone or in combination with other methods," including oral and topical medications.

The primary outcome measure assessed in this meta-analysis was the effective rate, defined as the percentage of patients clinically cured (pruritis resolved completely), reporting treatment to be markedly effective (pruritis significantly relieved), and reporting treatment to be effective (pruritis relieved to a certain extent).

In the acupuncture groups, LI-11 (Quchi) and ST-36 (Zusanli) acupoints were used in four studies; SP-10 (Xuehai) and SP-6 (Sanyinjiao) points in two studies; while one study also used LI-4 (Hegu) and DU-20 (Baihui) Treatment frequency in the seven studies was 2-3 sessions per week, with treatment periods ranging from 2-10 weeks.

Various control-group interventions in the studies included oral antihistamines, topical medications, hemodialysis, hemodiafiltration, calcium / phosphorus metabolism regulation, and blood-pressure control.

Results of the meta-analysis demonstrate that "acupuncture treatment may have similar efficacy to oral antihistamines and topical medications. Interestingly, hemodialysis combined with acupuncture was more effective in relieving pruritus than hemodialysis alone."

Clinical / Public-Health Relevance

Muscle wasting and pruritis are common in dialysis patients, with an estimated 50 percent of patients on chronic dialysis experiencing loss of muscle mass; and approximately one-third of patients experiencing pruritis. These findings suggest acupuncture is useful as a supportive treatment modality.

References

1. Jing Y, et al. Effects of warm acupuncture therapy on sarcopenia in maintenance hemodialysis patients and its effect on serum irisin and TNF-a. Shanghai J Acupuncture Moxib, Dec 2022;41(2).

2. Zhang L, et al. Acupuncture for uremic pruritus: a systematic review and meta-analysis. J Pain Symptom Management, Jan 2023;65(1):e51-62.

Page printed from: http://www.acupuncturetoday.com/mpacms/at/article.php? id=34327&s=60348&l=14&no_paginate=true&p_friendly=true&no_b=true 

November 2015: My dad has been diagnosed with cancer. He’d been dealing with a mystery. Now it has a name. Cancer. The C word. Cancer is the Voldermort of disease (if you don’t know who he is, that’s because he cannot be named). Cancer strikes fear in everyone.

My dad helps people. He will do anything within his power to help someone else, and he doesn’t ask for anything in return. He builds, installs and fixes anything and everything: fences, walls, broken faucets, leaky roofs, anything electronic, and even my mom’s ridiculous yard creature decoration thingies. He will make you a pot of coffee. He will offer you a room to stay. He once crossed a flooded river for my mom, in a storm, in the dark. True story.

He (and his sister) cared for his brother during the last few months of his brother’s life. He lost his brother to cancer. He lost both his parents to emphysema and both his stepparents to lung cancer.

As amazing as he is at helping other people, in his 70’s, he’s sill learning how to take care of himself. He needs a project, an assignment, something to fix. His attention is focused outward. His body has been a tool to get things done. He seems disconnected from his body. He doesn’t know the difference between muscle “work” pain and “injury” pain. He is unable to distinguish between muscle and bone. He doesn’t know the difference between his hip and his back. Now, his body has betrayed him.

My dad has never been a leader. He serves from duty, not from vision. He serves others because he believes it is the right thing to do, not because he knows where he’s going. Throughout his life, he has declined to step into a leadership role. He would prefer someone else make the decisions. Decisions overwhelm him. He was recently elected to local office. His terms were this: “I will serve if no one else will. If someone else wants it, please remove my name from the ballot.”

My dad worries. This is no surprise to anyone who has ever met him. He will tell you he’s not worried, as he furrows his brow like a sharpei-pug puppy mix. His facial expressions and body language give him away every time. He’s a terrible liar.

So, when the mystery was solved and the diagnosis was cancer, I assumed that he would literally worry himself to death because he wouldn’t know how to fix himself. Not in touch with his body, doesn’t want to lead, and never asks for help. I was wrong.

I was absolutely wrong! We are about to enter round three of six (chemotherapy treatments). I have never seen him more positive in my 45+ years. I’ve heard people talk about how cancer has transformed their lives for the better. How being a survivor makes them appreciate life. It was difficult to understand. Now I see it. Now he has something to fix.

We never know what people are capable of until they reach their flooded river, in the storm, in the dark. He has reached his river, and he is crossing it. He doesn’t have to lead. He doesn’t have to ask for help. He is not alone. He has built his legacy by helping others. Through that legacy, he has built his team. Team Karl.

I found acupuncture by mistake. I was terrified of needles. I’m still afraid of hospital style needles. In early 2012, I was training for my first Kettlebell Sport competition. I’d never been an athlete. Did I mention that I was over 40? That's why my knee and elbow were sore. Right? 

Completely against my will, my Kettlebell Sport Coach made me go to an acupuncturist. I rolled my eyes at both of them. Looking back, I'm sure I was embarrassingly condescending about the “fact” that I knew the acupuncturist couldn’t help me. Obviously, she did. I didn’t even feel the needles! We fixed the elbow and knee right away and started working on the things that had plagued me for my entire adult life: ALLERGIES!  And the rest, as they say... is history!

By the way, acupuncture needles are tiny, tiny, tiny! Closer to the size of a human hair than of those horrifyingly ginormous hospital needles. Yet, they can be amazingly powerful! I specialize in a style of acupuncture that is comfortable, safe, and effective. It’s excellent for chronic conditions such as diabetes, allergies, and autoimmunities. Also, acupuncture ROCKS at supporting the body during times of crisis such as emotional trauma or chemotherapy.