Chronic kidney disease (CKD) is an important global public health problem. According to
related literatures, the prevalence of CKD is about 11% .CKD is a progressive disease. If it
progresses to end-stage renal disease (ESRD), renal replacement therapy: dialysis and renal
transplantation, is required to maintain life. The growing prevalence and progression of
chronic kidney disease (CKD) raises concerns about our capacity to manage its economic burden
to patients, caregivers, and society. The societal direct and indirect costs of CKD and
end-stage renal disease are substantial and increase throughout disease progression. There is
significant variability in the evidence about direct and indirect costs attributable to CKD
and end-stage renal disease, with the most complete evidence concentrated on direct health
care costs of patients with advanced to end-stage CKD.
CKD, also called chronic kidney failure, is described as a sustained reduction in glomerular
filtration rate or evidence of structural or functional kidney abnormalities.Chronic kidney
disease (CKD) refers to all five stages of kidney damage, from very mild damage in stage 1 to
complete kidney failure in stage 5. CKD symptoms include pain, itch(pruritus), peripheral
numbness, sleep disturbances, depression, fatigue, nausea and vomiting. Factors that
contribute to these symptoms include anaemia, uraemic toxins, reduced renal capacity, chronic
disease-related inflammation, and psychological stress associated with long-term illness.If
it progresses to end-stage renal disease (ESRD), renal replacement therapy, including
hemodialysis, peritoneal dialysis and kidney transplantation, is required to maintain life.
Therefore, it is essential to find effective and conservative treatment methods to delay the
progression of CKD.
Diagnosis in traditional Chinese medicine (TCM) is based on four procedures, observation,
smelling or listening, inquiry, and palpation. Tongue diagnosis, serving as a vital
non-invasive tool to provide useful clinical information, plays a pivotal role in TCM. The
tongue is considered to reflect the physiological and pathological condition of the body, as
well as the degree and progression of disease, through the meridians that connect the tongue
to the internal organs.By observing tongue features, TCM practitioners can probe qi-blood,
yin-yang disorders which are important in treatment selection and prognosis.Clinically,
practitioners observe tongue characteristics, such as tongue color and shape, fur color and
thickness, and the amount of saliva, to help deduce the primary pattern of a patient.
However, tongue diagnosis is often biased by subjective judgment, which originates from
personal experience, knowledge, diagnostic skills, thinking patterns, and color
perception/interpretation.The inconsistency of subjective diagnosis can be improved by using
the development of validated instruments. The automatic tongue diagnosis system (ATDS) has
shown high consistency and can provide objective and reliable information and analysis of
tongue features, facilitating doctors in making effective observations and diagnoses of
specific diseases.Previous studies have been conducted on exploring the association between
tongue characteristics and specific diseases, including rheumatoid arthritis,
breastcancer,type 2 diabetes, metabolic syndrome, eczema, dysmenorrhea and functional
dyspepsia, gastroesophageal reflux disease.However, to the best of our knowledge, no study
has yet been performed on the comprehensive scrutiny of tongue features in patients with CKD
using ATDS.
The objectives of this protocol are to apply the noninvasive ATDS to evaluate tongue
manifestations in patients with CKD, and to provide valuable information for clinical
doctors, which can be used to facilitate the early detection and diagnosis of CKD, to analyze
the current status of patients, and to dynamically schedule treatment plans.
