Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.
About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.
A systematic review (Melo et al, 2020) examined acupuncture’s effect in CKD over 9 RCT’s, finding positive effects on improving quality of life, fatigue, and sleep in patients with chronic kidney disease, but not on the clinical variables of the disease, such as serum creatinine and glomerular filtration rate.
According to Lui et al’s (2022) narrative overview of preclinical studies and clinical trials published in Frontiers in Nephrology, acupuncture has been shown to improve symptoms and delay the progress of chronic kidney disease (CKD). The review suggests that acupuncture may be effective in reducing albuminuria, improving glomerular filtration rate, relieving symptoms, and improving the quality of life of patients with CKD.
Specifically, in diabetic patients with CKD, a prospective RCT (Wang et al, 2014; n=59) found that auricular (ear) acupuncture may have positive effects on improving the quality of life in these patients. The auricular acupressure group had significantly higher SF-36 (Short Form-36 Health Survey) scores and lower PSQI (Pittsburgh Sleep Quality Index) scores compared to the control group, indicating improvements in quality of life and sleep quality.
A preliminary small study (Yu et al, 2017; n=53) found acupuncture at points LI4, St36, and Kid3 for 12 weeks reduced creatinine levels and increased eGFR levels in patients with CKD.
Possible mechanisms of action of acupuncture in CKD include, per Lui et al, 2022, include “oxidative stress inhibition, reducing inflammatory effects, improving haemodynamics, maintaining podocyte structure, and increasing energy metabolism” [sic], leading the researchers to conclude that acupuncture could potentially present a safe, inexpensive treatment modality toward CKD, to improve patient symptoms and slow the progress of renal dysfunction.
Fatigue in End Stage Renal Disease (ESRD)
Hadadian et al (2016) found positive effects from Transcutaneous Electrical Acupoint Stimulation (TEAS) on fatigue among ESRD patients receiving haemodialysis treatment.
Shariati et al’s RCT (2012; n=48) found acupressure beneficial for end-stage renal disease patients on haemodialysis, with Ht7, Li4 and SP6 points used, significant differences in the PSQI (Pittsburgh Sleep Quality Index) and other sleep measures of duration, and daytime function were seen between the acupressure group and the control group after intervention.
Haemodialysis side effects
An RCT (Hmwe et al. 2015; n=108), examined the effects of acupressure on depression, anxiety, and general psychological distress in patients with haemodialysis, finding it could have positive effects on improving the psychological wellbeing of patients. The acupressure group had significantly lower DASS-21 (Depression, Anxiety Stress Scales) scores and GHQ-28 (General Health Questionnaire) scores compared to the control group, indicating improvements in depression, anxiety, stress, and general psychological distress.
Studies by both Sabouhi et al (2013; n=96) and Eglence et al (2013; n=118).found acupressure to reduce fatigue in haemodialysis patients.
Renal Calculi – Kidney Stones, renal colic
Acupuncture has also been used for the management of renal colic caused by urinary calculi (kidney stones), as one of the main issues involved pain management, and the mechanisms of action of acupuncture in pain are well-understood. See our page, for example on Chronic Pain.
Acupuncture at Neiguan (PC 6) and Zusanli (ST 36) points was shown in a Chinese RCT (n=240) to have a good analgesic (painkilling) effect in renal colic pain with a low incidence of adverse reactions, this was compared to two groups who each received pharmaceutical treatments.
Wu et al (2023; n=82) also found acupuncture beneficial for acute pain in patients with urinary calculi, as did Zhang et al, 2021 (n=80), in comparison with drug treatment.
A later RCT study (Tu et al, 2022, n=80) combined acupuncture with diclofenac drug treatment in the emergency department for patients with acute renal colic due to urolithiasis (stones); they concluded that acupuncture combined with diclofenac injection to be safe, providing fast, effective pain relief.
Qu et al (2022) conducted a systematic review and meta-analysis of acupuncture in renal colic caused by urinary calculi; over 15 studies they found acupuncture an effective and safe adjuvant therapy for kidney stone pain.
Later, Chen et al’s (2023) meta-analysis and trial sequence analysis examined 13 studies (n=1212) comparing conventional medicinal painkillers with acupuncture, finding acupuncture to be able to efficiently relieve renal colic with fewer adverse effects than those seen in pharmaceutical approaches. Both Que et al, and Chen et al (2022; 2023) noted some limitations in the number and quality of studies, warranting further future RCTs in this area.
Forthcoming is a study protocol for a randomized controlled trial published in Trials aims to evaluate the efficacy and safety of acupuncture as an adjunctive treatment to diclofenac for acute renal colic caused by urinary calculi (Cao et al, 2021).
During extracorporeal shock wave lithotripsy (ESWL) for kidney stones
Clinical studies by Tavakoli et al (2014); Rogenhofer et al (2004; n=90); Agah et al (2004; n=100) and Medina et al (2005; ) all found acupuncture effective on pain during ESWL.
A meta-analysis and systematic review of studies into acupuncture during ESWL (Chen et al, 2023b; n=1220), found acupuncture associated with higher pain relief and low side effect profile and supported the efficacy of acupuncture for pain relief during and after ESWL.
Agah M, Falihi A. The efficacy of acupuncture in extracorporeal shock wave lithotripsy. Urol J. 2004 Summer;1(3):195-9.
Cao, Y., Tu, J.F., Shi, G.X., Wang, L.Q., Jia, L.C., Li, B., Liu, B.L., Yao, W.H., Pei, X.L., Qu, Z.C. and Liu, C.Z., 2021. Acupuncture as adjunctive therapy for acute renal colic caused by urinary calculi: study protocol for a randomized controlled trial. Trials, 22(1), pp.1-8.
Chen, H.T., Kuo, C.F., Hsu, C.C., Lai, L.C., Cheng, A.C., Sun, C.K. and Hung, K.C., 2023. Clinical efficacy of acupuncture for pain relief from renal colic: A meta-analysis and trial sequence analysis. Frontiers in Medicine, 9, p.1100014.
Chen, H.T., Hung, K.C., Hsu, Y.C., Kuo, J.R., Chang, Y.J., Chen, I.W. and Sun, C.K., 2023b. Efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy: a meta-analysis of randomized controlled studies. Frontiers in Medicine, 10, p.1114485.
Eglence, R., Karatas, N. and Tasci, S., 2013. The effect of acupressure on the level of fatigue in hemodialysis patients. Alternative Therapies in Health and Medicine, 19(6), p.23.
Hmwe, N.T.T., Subramanian, P., Tan, L.P. and Chong, W.K., 2015. The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: A randomized controlled trial. International journal of nursing studies, 52(2), pp.509-518.
Hadadian, F., Sohrabi, N., Farokhpayam, M., Farokhpayam, H., Towhidi, F., Fayazi, S., Soroush, A. and Abdi, A., 2016. The effects of transcutaneous electrical acupoint stimulation (TEAS) on fatigue in haemodialysis patients. Journal of Clinical and Diagnostic Research: JCDR, 10(9), p.YC01.
Ju, B.J. and Niu, L.L., 2012. Analysis of therapeutic effect of acupuncture at neiguan (PC 6) and zusanli (ST 36) on acute renal colic. Zhongguo Zhen jiu= Chinese Acupuncture & Moxibustion, 32(11), pp.975-978.
Liu, X., Wang, X., Ma, H. and Zhang, W., 2022. Mechanisms underlying acupuncture therapy in chronic kidney disease: A narrative overview of preclinical studies and clinical trials. Frontiers in Nephrology, 2, p.1006506.
Melo, G.A.A., Aguiar, L.L., Silva, R.A., Pereira, F.G.F., Silva, F.L.B.D. and Caetano, J.Á., 2020. Effects of acupuncture in patients with chronic kidney disease: a systematic review. Revista Brasileira de Enfermagem, 73, p.e20180784.
Qu, Z., Wang, T., Tu, J., Yao, W., Pei, X., Jia, L., Cao, Y. and Liu, C., 2022. Efficacy and safety of acupuncture in renal colic caused by urinary calculi in adults: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2022.
Rogenhofer S, Wimmer K, Blana A, Roessler W, Wieland WF, Filbeck T. Acupuncture for pain in extracorporeal shockwave lithotripsy. J Endourol. 2004 Sep;18(7):634-7.
Sabouhi, F., Kalani, L., Valiani, M., Mortazavi, M. and Bemanian, M., 2013. Effect of acupressure on fatigue in patients on hemodialysis. Iranian journal of nursing and midwifery research, 18(6), p.429.
Shariati, A., Jahani, S., Hooshmand, M. and Khalili, N., 2012. The effect of acupressure on sleep quality in hemodialysis patients. Complementary therapies in medicine, 20(6), pp.417-423.
Tu, J.F., Cao, Y., Wang, L.Q., Shi, G.X., Jia, L.C., Liu, B.L., Yao, W.H., Pei, X.L., Cao, Y., Li, H.W. and Yan, S.Y., 2022. Effect of adjunctive acupuncture on pain relief among emergency department patients with acute renal colic due to urolithiasis: a randomized clinical trial. JAMA Network Open, 5(8), pp.e2225735-e2225735.
Tavakoli K, Taghavi R, Barakati N, Mohammadi SH. The effect of acupuncture on pain during extracorporeal shock wave lithotripsy- a clinical trial. J Shahrekord Univ Med Sci. 2014; 16(5): 84-91.
Wang, S., Chen, Z., Fu, P., Zang, L., Wang, L., Zhai, X., Gao, F., Huang, A. and Zhang, Y., 2014. Use of auricular acupressure to improve the quality of life in diabetic patients with chronic kidney diseases: a prospective randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2014.
Wu, L.M., Liu, Q., Yin, X.H., Yang, L.P., Yuan, J., Zhang, X.Q. and Wang, Y.L., 2023. Wrist-ankle acupuncture combined with pain nursing for the treatment of urinary calculi with acute pain. World Journal of Clinical Cases, 11(18), pp.4287-4294.
Yu, J.S., Ho, C.H., Wang, H.Y., Chen, Y.H. and Hsieh, C.L., 2017. Acupuncture on renal function in patients with chronic kidney disease: a single-blinded, randomized, preliminary controlled study. The Journal of Alternative and Complementary Medicine, 23(8), pp.624-631.
Zhang, X., Liu, X., Ye, Q., Wang, X., Chen, J., Wang, Z., Zhao, P., Tao, B., Xu, G., Xu, W. and Wu, K., 2021. Acupuncture versus lornoxicam in the treatment of acute renal colic: a randomized controlled trial. Journal of Pain Research, pp.3637-3648.