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143-416: Paraherbalism describes alternative and pseudoscientific practices of using unrefined plant or animal extracts as unproven medicines or health-promoting agents. Paraherbalism relies on the belief that preserving various substances from a given source with less processing is safer or more effective than manufactured products, a concept for which there is no evidence. Archaeological evidence indicates that

286-546: A 'dietary supplement', though the FDA may withdraw a product from sale should it prove harmful. Canadian regulations are described by the Natural and Non-prescription Health Products Directorate which requires an eight-digit Natural Product Number or Homeopathic Medicine Number on the label of licensed herbal medicines or dietary supplements. Some herbs, such as cannabis and coca , are outright banned in most countries though coca

429-471: A 2018 interview with The BMJ , Edzard Ernst stated: "The present popularity of complementary and alternative medicine is also inviting criticism of what we are doing in mainstream medicine. It shows that we aren't fulfilling a certain need-we are not giving patients enough time, compassion, or empathy. These are things that complementary practitioners are very good at. Mainstream medicine could learn something from complementary medicine." Alternative medicine

572-506: A 2018 study, the FDA identified active pharmaceutical additives in over 700 analyzed dietary supplements sold as "herbal", "natural" or "traditional". The undisclosed additives included "unapproved antidepressants and designer steroids", as well as prescription drugs , such as sildenafil or sibutramine . Researchers at the University of Adelaide found in 2014 that almost 20 percent of herbal remedies surveyed were not registered with

715-626: A CKDu referred to as the Mesoamerican nephropathy (MeN). It was estimated in 2013 that at least 20,000 men had died prematurely, some in their 20s and 30s; a figure of 40,000 per year was estimated in 2020. In some affected areas CKD mortality was five times the national rate. MeN primarily affects men working as sugarcane labourers. The cause is unknown, but in 2020 the science found a clearer connection between heavy labour in high temperatures and incidence of CKDu; improvements such as regular access to water, rest and shade, can significantly decrease

858-501: A basis as herbal remedies, including artemisinin , digitalis , quinine and taxanes . In 2015, the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance ; herbalism was one of 17 topics evaluated for which no clear evidence of effectiveness was found. Establishing guidelines to assess

1001-472: A classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy , colorpuncture and light therapy ) and putative , which invokes physically undetectable or unverifiable energy. None of these energies have any evidence to support that they affect

1144-414: A corresponding increase in success of its treatments. In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine". Use of alternative medicine in the west began to rise following

1287-446: A culture which have existed since before the advent of medical science, Many TM practices are based on "holistic" approaches to disease and health, versus the scientific evidence-based methods in conventional medicine. The 2019 WHO report defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in

1430-461: A customer should inform a herbalist of their consumption of actual prescription and other medication. For example, dangerously low blood pressure may result from the combination of a herbal remedy that lowers blood pressure together with prescription medicine that has the same effect. Some herbs may amplify the effects of anticoagulants. Certain herbs as well as common fruit interfere with cytochrome P450, an enzyme critical to much drug metabolism. In

1573-694: A family history of chronic kidney disease. Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin . Ultrasound or kidney biopsy may be performed to determine the underlying cause. Several severity-based staging systems are in use. Screening at-risk people is recommended. Initial treatments may include medications to lower blood pressure, blood sugar, and cholesterol. Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are generally first-line agents for blood pressure control, as they slow progression of

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1716-451: A gradual transition can help preserve remaining kidney function. More research is ongoing to improve CKD management and patient outcomes. Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) are recommended as first-line agents since they have been found to slow the decline of kidney function, relative to a more rapid decline in those not on one of these agents. They have also been found to reduce

1859-610: A high-flux membrane, hemodiafiltration and hemofiltration. However, conventional dialysis treatment is limited in its ability to remove protein-bound uremic toxins. CKD increases the risk of cardiovascular disease, and people with CKD often have other risk factors for heart disease, such as high blood lipids . The most common cause of death in people with CKD is cardiovascular disease rather than kidney failure. Chronic kidney disease results in worse all-cause mortality (the overall death rate) which increases as kidney function decreases. The leading cause of death in chronic kidney disease

2002-439: A history of kidney disease in the past, and subjects who have relatives who had kidney disease requiring dialysis. Screening should include calculation of the estimated GFR (eGFR) from the serum creatinine level, and measurement of urine albumin-to-creatinine ratio (ACR) in a first-morning urine specimen (this reflects the amount of a protein called albumin in the urine), as well as a urine dipstick screen for hematuria. The GFR

2145-423: A kidney transplant for survival. Chronic kidney disease affected 753 million people globally in 2016 (417 million females and 336 million males.) In 2015, it caused 1.2 million deaths, up from 409,000 in 1990. The causes that contribute to the greatest number of deaths are high blood pressure at 550,000, followed by diabetes at 418,000, and glomerulonephritis at 238,000. CKD is initially without symptoms, and

2288-409: A lower ethanol percentage than tinctures. They are usually made by vacuum distilling tinctures. Dry extracts are extracts of plant material that are evaporated into a dry mass. They can then be further refined to a capsule or tablet. The exact composition of a herbal product is influenced by the method of extraction. A tea will be rich in polar components because water is a polar solvent . Oil on

2431-435: A method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine. Much of the perceived effect of an alternative practice arises from a belief that it will be effective, the placebo effect , or from the treated condition resolving on its own ( the natural course of disease ). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point

2574-503: A mixture of pure ethanol with water) with the herb. A completed tincture has an ethanol percentage of at least 25% (sometimes up to 90%). Non-alcoholic tinctures can be made with glycerin but it is believed to be less absorbed by the body than alcohol based tinctures and has a shorter shelf life. Herbal wine and elixirs are alcoholic extracts of herbs, usually with an ethanol percentage of 12–38%. Extracts include liquid extracts, dry extracts, and nebulisates. Liquid extracts are liquids with

2717-766: A negative impact in CKD, increasing the risk of disease progression to ESKD or kidney failure compared to controls with healthy weight, and when in advanced stages also may hinder people's eligibility to kidney transplantation . For example, the consumption of high calorie and high fructose beverages can make an individual "60% more likely to develop CKD". Weight management interventions in overweight and obese adults with CKD include lifestyle inverventions (dietary changes, physical activity / exercise , or behavioural strategies), pharmacological (used to reduce absorption or suppress appetite ) and surgical interventions. Any of these can help people with CKD loose weight, however, it

2860-431: A non-drug approach to treating some health conditions. In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the post hoc, ergo propter hoc fallacy. In

3003-577: A particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices. Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine ,

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3146-536: A patient's condition even though the objective effect is non-existent, or even harmful. David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine. Almost none have performed significantly better than a placebo in clinical trials. Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication. A patient who receives an inert treatment may report improvements afterwards that it did not cause. Assuming it

3289-494: A person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category. Edzard Ernst , the first university professor of Complementary and Alternative Medicine, characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Ernst has concluded that 95% of

3432-428: A physical means of purging intestinal parasites. Sick animals tend to forage plants rich in secondary metabolites , such as tannins and alkaloids . Alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility , testability , repeatability or evidence of effectiveness. Unlike modern medicine , which employs

3575-582: A project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis . According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. As of 2005 , the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of

3718-554: A reference range may reinforce stereotypes and perpetuate health disparities. This approach fails to account for the complex interplay of genetic, environmental, and social factors influencing kidney function. Depending solely on race-based metrics may lead to misdiagnosis or underdiagnosis in minority populations. Alternative approaches that consider socioeconomic status, environmental exposures, and genetic vulnerability, are needed to accurately assess kidney function and address CKD care disparities. The International Society of Nephrology

3861-646: A research institute for integrative medicine (a member entity of the Cochrane Collaboration ). Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD). All states require that applicants for MD licensure be graduates of an approved medical school and complete

4004-541: A result of reforms following the Flexner Report of 1910 medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic. Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Medical schools' teaching includes such topics as doctor-patient communication, ethics,

4147-487: A single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies. By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Exceptionally, the School of Medicine of the University of Maryland, Baltimore , includes

4290-638: A specific profession of herb mixer and combiner (herbalist), called Acaraki . The book from Mataram dated from circa 1700 contains 3,000 entries of jamu herbal recipes, while Javanese classical literature Serat Centhini (1814) describes some jamu herbal concoction recipes. Though possibly influenced by Indian Ayurveda systems, the Indonesia archipelago holds numerous indigenous plants not found in India, including plants similar to those in Australia beyond

4433-528: A sudden increase in the serum creatinine (several days to weeks). In many people with CKD, previous kidney disease or other underlying diseases are already known. A significant number present with CKD of unknown cause. Screening those who have neither symptoms nor risk factors for CKD is not recommended. Those who should be screened include: those with hypertension or history of cardiovascular disease, those with diabetes or marked obesity, those aged > 60 years, subjects with African American ancestry, those with

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4576-955: A test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias , and misleading wording of questions. In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding ." Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment. Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer

4719-550: A topical. Salves , oils, balms , creams, and lotions are other forms of topical delivery mechanisms. Most topical applications are oil extractions of herbs. Taking a food grade oil and soaking herbs in it for anywhere from weeks to months allows certain phytochemicals to be extracted into the oil. This oil can then be made into salves, creams, lotions, or simply used as an oil for topical application. Many massage oils, antibacterial salves, and wound healing compounds are made this way. Inhalation , as in aromatherapy , can be used as

4862-556: A traditional Chinese treatment for intermittent fevers. In India, Ayurvedic medicine has quite complex formulas with 30 or more ingredients, including a sizable number of ingredients that have undergone " alchemical processing ", chosen to balance dosha . In Ladakh, Lahul-Spiti, and Tibet, the Tibetan Medical System is prevalent, also called the "Amichi Medical System". Over 337 species of medicinal plants have been documented by C.P. Kala . Those are used by Amchis,

5005-624: A treatment to be harmful will perceive harmful effects after taking it. Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect. However, reassessments found the study to have flawed methodology. This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered. All of these are reasons why alternative therapies may be credited for improving

5148-616: A treatment. It is a popular misconception that herbal medicines are safe and side-effect free. Consumption of herbs may cause adverse effects . Furthermore, "adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions have led to adverse reactions that are sometimes life threatening or lethal." Proper double-blind clinical trials are needed to determine the safety and efficacy of each plant before medical use. Although many consumers believe that herbal medicines are safe because they are natural, herbal medicines and synthetic drugs may interact, causing toxicity to

5291-436: A wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Methods may incorporate or be based on traditional medicinal practices of

5434-438: Is a conspiracy to suppress safe and effective herbs, herbs cannot cause harm, whole herbs are more effective than molecules isolated from the plants, herbs are superior to drugs, the doctrine of signatures (the belief that the shape of the plant indicates its function) is valid, dilution of substances increases their potency (a doctrine of the pseudoscience of homeopathy ), astrological alignments are significant, animal testing

5577-404: Is a common complication from CKD. Children with CKD will be shorter than 97% of children the same age and sex. This can be treated with additional nutritional support, or medication such as growth hormone . Survival rates of CKD are generally longer with dialysis than without (having only conservative kidney management). However, from the age of 80 and in elderly patients with comorbidities there

5720-656: Is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma" . End-stage kidney disease Chronic kidney disease ( CKD ) is a type of long-term kidney disease , in which either there is a gradual loss of kidney function which occurs over a period of months to years, or an abnormal kidney structure (with normal function). Initially generally no symptoms are seen, but later symptoms may include leg swelling , feeling tired, vomiting , loss of appetite, and confusion . Complications can relate to hormonal dysfunction of

5863-496: Is a serious condition often linked to diabetes and high blood pressure. There is no cure, but a combination of lifestyle changes and medications can help slow its progression. This might include a plant-dominant diet with less protein and salt, medications to control blood pressure and sugar, and potentially newer anti-inflammatory drugs. Doctors may also focus on managing heart disease risk, preventing infections, and avoiding further kidney damage. While dialysis may eventually be needed,

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6006-634: Is an international body representing specialists in kidney diseases. It was said to be costing the National Health Service about £1.5 billion a year in 2020. Kidney Care UK and The UK National Kidney Federation represent people with chronic kidney disease. The Renal Association represents Kidney physicians and works closely with the National Service Framework for kidney disease. Kidney Health Australia serves that country. The incidence rate of CKD in dogs

6149-543: Is banned in the European Union), St. John's wort , khat , betel nut , the restricted herb ephedra , and guarana . There is also concern with respect to the numerous well-established interactions of herbs and drugs. In consultation with a physician, usage of herbal remedies should be clarified, as some herbal remedies have the potential to cause adverse drug interactions when used in combination with various prescription and over-the-counter pharmaceuticals, just as

6292-460: Is based on belief systems not grounded in science. Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world. Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted. Traditional medicine

6435-426: Is cardiovascular disease, regardless of whether there is progression to stage 5. While kidney replacement therapies can maintain people indefinitely and prolong life, the quality of life is negatively affected. Kidney transplantation increases the survival of people with stage 5 CKD when compared to other options; however, it is associated with an increased short-term mortality due to complications of

6578-450: Is common and intensity of end-of-life care is highly variable among people opting out of dialysis. About one in ten people have chronic kidney disease. In Canada 1.9 to 2.3 million people were estimated to have CKD in 2008. CKD affected an estimated 16.8% of U.S. adults aged 20 years and older in the period from 1999 to 2004. In 2007 8.8% of the population of Great Britain and Northern Ireland had symptomatic CKD. Chronic kidney disease

6721-406: Is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition. Bases of belief may include belief in existence of supernatural energies undetected by

6864-490: Is considered normal without chronic kidney disease if there is no kidney damage present. Kidney damage is defined signs of damage seen in blood, urine, or imaging studies which includes lab albumin/creatinine ratio (ACR) ≥ 30. All people with a GFR <60 mL/min/1.73 m for 3 months are defined as having chronic kidney disease. Protein in the urine is regarded as an independent marker for worsening of kidney function and cardiovascular disease. Hence, British guidelines append

7007-462: Is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, but whose effectiveness has not been established using scientific methods , or whose theory and practice is not part of biomedicine , or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. "Biomedicine" or "medicine"

7150-450: Is derived from the serum creatinine and is proportional to 1/creatinine, i.e. it is a reciprocal relationship; the higher the creatinine, the lower the GFR. It reflects one aspect of kidney function, how efficiently the glomeruli – the filtering units – work. The normal GFR is 90–120 ml/min. The units of creatinine vary from country to country, but since the glomeruli make up <5% of the mass of

7293-467: Is glomerular sclerosis, tubular atrophy, interstitial fibrosis, or inflammation, the result is often increased echogenicity of the cortex. The echogenicity of the kidney should be related to the echogenicity of either the liver or the spleen. Moreover, decreased kidney size and cortical thinning are also often seen and especially when disease progresses. However, kidney size correlates to height, and short persons tend to have small kidneys; thus, kidney size as

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7436-403: Is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven". Anything classified as alternative medicine by definition does not have a proven healing or medical effect. However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to

7579-646: Is legal in most of the South American countries where it is grown. The Cannabis plant is used as a herbal medicine , and as such is legal in some parts of the world. Since 2004, the sales of ephedra as a dietary supplement is prohibited in the United States by the FDA, and subject to Schedule III restrictions in the United Kingdom. Herbalism has been criticized as a potential " minefield " of unreliable product quality, safety hazards, and

7722-557: Is more than 30 mg/mmol, when blood pressure is difficult to control, or when hematuria or other findings suggest either a primarily glomerular disorder or secondary disease amenable to specific treatment. Other benefits of early nephrology referral include proper education regarding options for kidney replacement therapy as well as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those people with chronic kidney disease opting for future hemodialysis. At stage 5 CKD, kidney replacement therapy

7865-455: Is no difference in survival between the two groups. Quality of life might be better for people without dialysis. People who had decide against dialysis treatment when reaching end-stage chronic kidney disease could survive several years and experience improvements in their mental well-being in addition to sustained physical well-being and overall quality of life until late in their illness course. However, use of acute care services in these cases

8008-518: Is not appropriate to indicate human effects, anecdotal evidence is an effective means of proving a substance works and herbs were created by God to cure disease. Tyler suggests that none of these beliefs have any basis in fact. Up to 80% of the population in Africa uses traditional medicine as primary health care. Native Americans used about 2,500 of the approximately 20,000 plant species that are native to North America. In Andean healing practices,

8151-676: Is not certain that protein supplements affect quality of life, life expectancy, inflammation or body composition . Intravenous (IV) iron therapy may help more than oral iron supplements in reaching target hemoglobin levels. However, allergic reactions may also be more likely following IV-iron therapy. People with CKD experience sleep disorders, thus unable to get quality sleep. There are several strategies that could help, such as relaxation techniques, exercise, and medication. Exercise may be helpful with sleep regulation and possibly decreases fatigue and depression in people with CKD. However, none of these options have been proven to be effective in

8294-868: Is not known if they can also prevent death or cardiovascular events like heart complications or stroke. It is recommended that weight management interventions should be individualised, according to a thorough patients' assessment regarding clinical condition, motivations and preferences. High dietary sodium intake may increase the risk of hypertension and cardiovascular disease. The effect of dietary restriction of salt in foods has been investigated in people with chronic kidney disease. For people with CKD, including those on dialysis, reduced salt intake may help to lower both systolic and diastolic blood pressure, as well as albuminuria . Some people may experience low blood pressure and associated symptoms, such as dizziness, with lower salt intake. The effect of salt restriction on extracellular fluid, oedema, and total body weight reduction

8437-416: Is not known. EHealth interventions may improve dietary sodium intake and fluid management for people with CKD. In people with CKD who require hemodialysis, there is a risk that vascular blockage due to clotting , may prevent dialysis therapy from being possible. Even though Omega-3 fatty acids contribute to the production of eicosanoid molecules that reduce clotting, it does not have any impact on

8580-461: Is often a legally restricted herb), Ayurvedic remedies , broom , chaparral , Chinese herb mixtures, comfrey , herbs containing certain flavonoids, germander , guar gum , liquorice root , and pennyroyal . Examples of herbs that may have long-term adverse effects include ginseng , the endangered herb goldenseal , milk thistle , senna , aloe vera juice , buckthorn bark and berry , cascara sagrada bark , saw palmetto , valerian , kava (which

8723-494: Is often required. While lower socioeconomic status contributes to the number of people affected with CKD, differences in the number of people affected by CKD are still evident between Africans and Whites when controlling for environmental factors. Although CKDu was first documented among sugar cane workers in Costa Rica in the 1970s, it may well have affected plantation labourers since the introduction of sugar cane farming to

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8866-525: Is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", a notion later echoed by Paul Offit : "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends." Alternative medicine consists of

9009-419: Is safer and potentially more effective, for which there is no evidence either condition applies. Phytochemical researcher Varro Eugene Tyler described paraherbalism as "faulty or inferior herbalism based on pseudoscience", using scientific terminology but lacking scientific evidence for safety and efficacy. Tyler listed ten fallacies that distinguished herbalism from paraherbalism, including claims that there

9152-480: Is sometimes derogatorily called " Big Pharma " by supporters of alternative medicine. Billions of dollars have been spent studying alternative medicine, with few or no positive results and many methods thoroughly disproven. The terms alternative medicine , complementary medicine , integrative medicine, holistic medicine , natural medicine , unorthodox medicine , fringe medicine , unconventional medicine , and new age medicine are used interchangeably as having

9295-710: Is that part of medical science that applies principles of biology , physiology , molecular biology , biophysics , and other natural sciences to clinical practice , using scientific methods to establish the effectiveness of that practice. Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay , religion, tradition, superstition , belief in supernatural energies, pseudoscience , errors in reasoning , propaganda, fraud, or other unscientific sources. Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. This can refer to

9438-426: Is the pseudoscientific use of extracts of plant or animal origin as supposed medicines or health-promoting agents. Phytotherapy differs from plant-derived medicines in standard pharmacology because it does not isolate and standardize the compounds from a given plant believed to be biologically active. It relies on the false belief that preserving the complexity of substances from a given plant with less processing

9581-426: Is unknown, it is called idiopathic . Diagnosis of CKD is largely based on history , examination , and urine dipstick combined with the measurement of the serum creatinine level. Differentiating CKD from acute kidney injury (AKI) is important because AKI can be reversible. One diagnostic clue that helps differentiate CKD from AKI is a gradual rise in serum creatinine (over several months or years) as opposed to

9724-400: Is usually detected on routine screening blood work by either an increase in serum creatinine , or protein in the urine . As the kidney function decreases, more unpleasant symptoms may emerge: The most common causes of CKD are diabetes mellitus , hypertension , and glomerulonephritis . About one of five adults with hypertension and one of three adults with diabetes have CKD. If the cause

9867-418: Is usually required, in the form of either dialysis or a kidney transplant . In CKD numerous uremic toxins accumulate in the blood. Even when ESKD (largely synonymous with CKD5) is treated with dialysis, the toxin levels do not go back to normal as dialysis is not that efficient. Similarly, after a kidney transplant, the levels may not go back to normal as the transplanted kidney may not work 100%. If it does,

10010-612: Is when alternative medicine is used together with mainstream functional medical treatment in a belief that it improves the effect of treatments. For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. Significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy . Several medical organizations differentiate between complementary and alternative medicine including

10153-546: The Committee on Herbal Medicinal Products . In the United States, herbal remedies are regulated dietary supplements by the Food and Drug Administration (FDA) under current good manufacturing practice (cGMP) policy for dietary supplements. Manufacturers of products falling into this category are not required to prove the safety or efficacy of their product so long as they do not make 'medical' claims or imply uses other than as

10296-609: The Ebers papyrus dates from about 1550 BCE, and covers more than 700 compounds, mainly of plant origin. The earliest known Greek herbals came from Theophrastus of Eresos who, in the 4th century BCE, wrote in Greek Historia Plantarum , from Diocles of Carystus who wrote during the 3rd century BCE, and from Krateuas who wrote in the 1st century BCE. Only a few fragments of these works have survived intact, but from what remains, scholars have noted overlap with

10439-770: The Therapeutic Goods Administration , despite this being a condition for their sale. They also found that nearly 60 percent of products surveyed had ingredients that did not match what was on the label. Out of 121 products, only 15 had ingredients that matched their TGA listing and packaging. In 2015, the New York Attorney General issued cease and desist letters to four major U.S. retailers ( GNC , Target , Walgreens , and Walmart ) who were accused of selling herbal supplements that were mislabeled and potentially dangerous. Twenty-four products were tested by DNA barcoding as part of

10582-660: The United States Medical Licensing Examination (USMLE). There is a general scientific consensus that alternative therapies lack the requisite scientific validation , and their effectiveness is either unproved or disproved. Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias , marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question

10725-1030: The Wallace Line . Jamu practices may vary from region to region, and are often not recorded, especially in remote areas of the country. Although primarily herbal, some Jamu materials are acquired from animals, such as honey , royal jelly , milk, and Ayam Kampung eggs . Herbalists tend to use extracts from parts of plants, such as the roots or leaves, believing that plants are subject to environmental pressures and therefore develop resistance to threats such as radiation, reactive oxygen species and microbial attack to survive, providing defensive phytochemicals of use in herbalism. Indigenous healers often claim to have learned by observing that sick animals change their food preferences to nibble at bitter herbs they would normally reject. Field biologists have provided corroborating evidence based on observation of diverse species, such as chickens, sheep, butterflies , and chimpanzees . The habit of changing diet has been shown to be

10868-569: The counterculture movement of the 1960s, as part of the rising new age movement of the 1970s. This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures ( cultural relativism ), and growing frustration and desperation by patients about limitations and side effects of science-based medicine. At

11011-798: The scientific method to test plausible therapies by way of responsible and ethical clinical trials , producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine and do not originate from using the scientific method, but instead rely on testimonials , anecdotes , religion, tradition, superstition , belief in supernatural " energies ", pseudoscience , errors in reasoning , propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine , pseudo-medicine , unorthodox medicine , holistic medicine , fringe medicine , and unconventional medicine , with little distinction from quackery . Some alternative practices are based on theories that contradict

11154-520: The "whole" person, in contrast to the supposed reductionism of medicine. Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Others say that alternative medicine cannot be precisely defined because of

11297-606: The Act [21 U.S.C. § 321(g)(1)], because they are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and/or intended to affect the structure or any function of the body" when no such evidence existed. During the COVID-19 pandemic , the FDA and U.S. Federal Trade Commission issued warnings to several hundred American companies for promoting false claims that herbal products could prevent or treat COVID-19 disease . The World Health Organization (WHO),

11440-648: The American Herbalist Guild, "there is currently no licensing or certification for herbalists in any state that precludes the rights of anyone to use, dispense, or recommend herbs." However, there are U.S. federal restrictions for marketing herbs as cures for medical conditions, or essentially practicing as an unlicensed physician. Over the years 2017–2021, the U.S. Food and Drug Administration (FDA) issued warning letters to numerous herbalism companies for illegally marketing products under "conditions that cause them to be drugs under section 201(g)(1) of

11583-547: The CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database. Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment. Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin . In

11726-1091: The Caribbean in the 1600s. In colonial times the death records of slaves on sugar plantations was much higher than for slaves forced into other labour. Denial of care in chronic kidney disease treatment and management is a significant issue for minority populations. This can be due to healthcare provider bias, structural barriers, and health insurance coverage disparities. Healthcare provider biases can lead to under-treatment, misdiagnosis, or delayed diagnosis. Structural barriers, such as lack of insurance and limited healthcare facilities, hinder access to timely care. Furthermore, health insurance coverage disparities, with minority populations lacking adequate coverage, contribute to these disparities. Denial of care worsens health outcomes and perpetuates existing health inequities. Race-based kidney function metrics, particularly normalizing creatinine, pose ethical challenges in diagnosing and managing chronic kidney disease (CKD). While certain racial and ethnic groups are at higher risk, using race as

11869-599: The Egyptian herbals. Seeds likely used for herbalism were found in archaeological sites of Bronze Age China dating from the Shang dynasty ( c.  1600  – c.  1046 BCE ). Over a hundred of the 224 compounds mentioned in the Huangdi Neijing , an early Chinese medical text, are herbs. Herbs were also commonly used in the traditional medicine of ancient India, where the principal treatment for diseases

12012-744: The UK National Health Service (NHS), Cancer Research UK , and the US Center for Disease Control and Prevention (CDC), the latter of which states that " Complementary medicine is used in addition to standard treatments" whereas " Alternative medicine is used instead of standard treatments." Complementary and integrative interventions are used to improve fatigue in adult cancer patients. David Gorski has described integrative medicine as an attempt to bring pseudoscience into academic science-based medicine with skeptics such as Gorski and David Colquhoun referring to this with

12155-417: The alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology , are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine. In 2003,

12298-408: The alternative treatment. A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery . The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the nocebo effect , when patients who expect

12441-496: The art of medicine, and engaging in complex clinical reasoning (medical decision-making). Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease,

12584-445: The body in any positive or health promoting way. The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes

12727-628: The breeds with the lowest rates. Cats with chronic kidney disease may have a buildup of waste products usually removed by the kidneys. They may appear lethargic, unkempt, and lose weight, and may have hypertension. The disease can prevent appropriate concentration of urine, causing cats to urinate greater volumes and drink more water to compensate. Loss of important proteins and vitamins through urine may cause abnormal metabolism and loss of appetite. The buildup of acids within blood can result in acidosis , which can lead to anemia (which can sometimes be indicated by pink or whitish gums, but by no means does

12870-482: The claims of efficacy of isolated examples where there is evidence for alternative therapies. The Scientific Review of Alternative Medicine points to confusions in the general population – a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy ) gets misattributed to an alternative medicine being taken;

13013-637: The conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However,

13156-477: The condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection , multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. cyanide poisoning from amygdalin , or

13299-583: The consumer. Herbal remedies can also be dangerously contaminated, and herbal medicines without established efficacy, may unknowingly be used to replace prescription medicines. Standardization of purity and dosage is not mandated in the United States, but even products made to the same specification may differ as a result of biochemical variations within a species of plant. Plants have chemical defense mechanisms against predators that can have adverse or lethal effects on humans. Examples of highly toxic herbs include poison hemlock and nightshade. They are not marketed to

13442-614: The creatinine level is often normal. The toxins show various cytotoxic activities in the serum and have different molecular weights, and some of them are bound to other proteins, primarily to albumin. Uremic toxins are classified into three groups as small water-soluble solutes, middle molecular-weight solutes, and protein-bound solutes. Hemodialysis with high-flux dialysis membrane, long or frequent treatment, and increased blood/dialysate flow has improved removal of water-soluble small molecular weight uremic toxins. Middle molecular weight molecules are removed more effectively with hemodialysis using

13585-539: The diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique , therapeutic practice and in their relationship to the medical mainstream. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another. Critics say

13728-635: The dominant health care system. They are used interchangeably with traditional medicine in some countries." The Integrative Medicine Exam by the American Board of Physician Specialties includes the following subjects: Manual Therapies , Biofield Therapies , Acupuncture , Movement Therapies, Expressive Arts, Traditional Chinese Medicine , Ayurveda , Indigenous Medical Systems , Homeopathic Medicine , Naturopathic Medicine , Osteopathic Medicine , Chiropractic , and Functional Medicine . Traditional medicine (TM) refers to certain practices within

13871-482: The established science of how the human body works; others appeal to the supernatural or superstitious to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive risk–benefit outcome probability. Research into alternative therapies often fails to follow proper research protocols (such as placebo -controlled trials, blind experiments and calculation of prior probability ), providing invalid results. History has shown that if

14014-424: The expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo . Journalist John Diamond wrote that "there

14157-509: The histories of complementary medicine and of integrative medicine . Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery. Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had

14300-781: The intentional ingestion of hydrogen peroxide ) or actively interfere with effective treatments. The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Complementary medicine ( CM ), complementary and alternative medicine ( CAM ), integrated medicine or integrative medicine ( IM ), and holistic medicine attempt to combine alternative practices with those of mainstream medicine. Traditional medicine practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Alternative methods are often marketed as more " natural " or " holistic " than methods offered by medical science, that

14443-536: The investigation, with all but five containing DNA that did not match the product labels. In some countries, formalized training and minimum education standards exist for herbalists, although these are not necessarily uniform within or between countries. In Australia, for example, the self-regulated status of the profession (as of 2009) resulted in variable standards of training, and numerous loosely formed associations setting different educational standards. One 2009 review concluded that regulation of herbalists in Australia

14586-447: The kidney disease and the risk of heart disease. Loop diuretics may be used to control edema and, if needed, to further lower blood pressure. NSAIDs should be avoided. Other recommended measures include staying active, and certain dietary changes such as a low-salt diet and the right amount of protein. Treatments for anemia and bone disease may also be required. Severe disease requires hemodialysis , peritoneal dialysis , or

14729-424: The kidney, the GFR does not indicate all aspects of kidney health and function. This can be done by combining the GFR level with the clinical assessment of the person, including fluid status, and measuring the levels of hemoglobin, potassium, phosphate, and parathyroid hormone. Kidney ultrasonography is useful for diagnostic and prognostic purposes in chronic kidney disease. Whether the underlying pathologic change

14872-550: The kidneys and include (in chronological order) high blood pressure (often related to activation of the renin–angiotensin system ), bone disease , and anemia . Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization. CKD can lead to kidney failure requiring kidney dialysis or kidney transplantation . Causes of chronic kidney disease include diabetes , high blood pressure , glomerulonephritis , and polycystic kidney disease . Risk factors include

15015-547: The lack of support that alternative therapies receive from medical scientists regarding access to research funding , sympathetic coverage in the medical press , or inclusion in the standard medical curriculum . For example, a widely used definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine" . However, these descriptive definitions are inadequate in

15158-486: The letter "P" to the stage of chronic kidney disease if protein loss is significant. The term "non-dialysis-dependent chronic kidney disease" (NDD-CKD) is a designation used to encompass the status of those persons with an established CKD who do not yet require the life-supporting treatments for kidney failure known as kidney replacement therapy (RRT, including maintenance dialysis or kidney transplantation ). The condition of individuals with CKD, who require either of

15301-512: The long-term boiled extracts, usually of harder substances like roots or bark. Maceration is the cold infusion of plants with high mucilage -content, such as sage or thyme . To make macerates, plants are chopped and added to cold water. They are then left to stand for 7 to 12 hours (depending on the herb used). For most macerates, 10 hours is used. Tinctures are alcoholic extracts of herbs, which are generally stronger than herbal teas. Tinctures are usually obtained by combining pure ethanol (or

15444-573: The loose terminology to give the appearance of effectiveness). Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not (e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asian east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work). Alternative medicine

15587-492: The maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness." When used outside the original setting and in the absence of scientific evidence, TM practices are typically referred to as "alternative medicine". Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative , claiming to take into fuller account

15730-406: The only parameter is not reliable. Additional tests may include nuclear medicine MAG3 scan to confirm blood flow and establish the differential function between the two kidneys. Dimercaptosuccinic acid (DMSA) scans are also used in kidney imaging; with both MAG3 and DMSA being used chelated with the radioactive element technetium-99 . A glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m

15873-461: The other hand is a non-polar solvent and it will absorb non-polar compounds. Alcohol lies somewhere in between. Many herbs are applied topically to the skin in a variety of forms. Essential oil extracts can be applied to the skin, usually diluted in a carrier oil. Many essential oils can burn the skin or are simply too high dose used straight; diluting them in olive oil or another food grade oil such as almond oil can allow these to be used safely as

16016-435: The pejorative term " quackademia ". Robert Todd Carroll described Integrative medicine as "a synonym for 'alternative' medicine that, at its worst, integrates sense with nonsense. At its best, integrative medicine supports both consensus treatments of science-based medicine and treatments that the science, while promising perhaps, does not justify" Rose Shapiro has criticized the field of alternative medicine for rebranding

16159-644: The period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Changes included relaxed medical licensing, the development of managed care , rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health). Mainly as

16302-907: The potential CKDu incidence. CKDu also affects people in Sri Lanka where it is the eighth largest cause of in-hospital mortality. African, Hispanics , and South Asians, particularly those from Pakistan, Sri Lanka, Bangladesh, and India, are at high risk of developing CKD. Africans are at greater risk due to the number of people affected with hypertension among them. As an example, 37% of ESKD cases in African Americans can be attributed to high blood pressure, compared with 19% among Caucasians. Treatment efficacy also differs between racial groups. Administration of antihypertensive drugs generally halts disease progression in white populations but has little effect in slowing kidney disease among black people, and additional treatment such as bicarbonate therapy

16445-739: The potential for misleading health advice. Globally, there are no standards across various herbal products to authenticate their contents, safety or efficacy, and there is generally an absence of high-quality scientific research on product composition or effectiveness for anti-disease activity. Presumed claims of therapeutic benefit from herbal products, without rigorous evidence of efficacy and safety, receive skeptical views by scientists. Unethical practices by some herbalists and manufacturers, which may include false advertising about health benefits on product labels or literature, and contamination or use of fillers during product preparation, may erode consumer confidence about services and products. Paraherbalism

16588-619: The practitioners of this medical system. The Indian book, Vedas, mentions treatment of diseases with plants. In Indonesia , especially among the Javanese , the jamu traditional herbal medicine may have originated in the Mataram Kingdom era, some 1300 years ago. The bas-reliefs on Borobudur depict the image of people grinding herbs with stone mortar and pestle , a drink seller, a herbalist, and masseuse treating people. The Madhawapura inscription from Majapahit period mentioned

16731-427: The present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies. Complementary medicine (CM) or integrative medicine (IM)

16874-441: The prevalence of herbal remedy use. There are many forms in which herbs can be administered, the most common of which is a liquid consumed as a herbal tea or a (possibly diluted) plant extract. Herbal teas , or tisanes, are the resultant liquid of extracting herbs into water, though they are made in a few different ways. Infusions are hot water extracts of herbs, such as chamomile or mint , through steeping . Decoctions are

17017-436: The prevention of vascular blockage in people with CKD. Regular consumption of oral protein-based nutritional supplements may increase serum albumin levels slightly in people with CKD, especially among those requiring hemodialysis or who are malnourished. Prealbumin level and mid-arm muscle circumference may also be increased following supplementation. Despite possible improvement in these indicators of nutritional status, it

17160-508: The public as herbs, because the risks are well known, partly due to a long and colorful history in Europe, associated with "sorcery", "magic" and intrigue. Although not frequent, adverse reactions have been reported for herbs in widespread use. On occasion serious untoward outcomes have been linked to herb consumption. A case of major potassium depletion has been attributed to chronic licorice ingestion, and consequently professional herbalists avoid

17303-407: The risk of major cardiovascular events such as myocardial infarction , stroke , heart failure , and death from cardiovascular disease when compared to placebo in individuals with CKD. ACEIs may be superior to ARBs for protection against progression to kidney failure and death from any cause in those with CKD. Aggressive blood pressure lowering decreases people's risk of death. Obesity may have

17446-619: The safety and efficacy of herbal products, the European Medicines Agency provided criteria in 2017 for evaluating and grading the quality of clinical research in preparing monographs about herbal products. In the United States, the National Center for Complementary and Integrative Health of the National Institutes of Health funds clinical trials on herbal compounds, provides fact sheets evaluating

17589-587: The safety, potential effectiveness and side effects of many plant sources, and maintains a registry of clinical research conducted on herbal products. According to Cancer Research UK as of 2015, "there is currently no strong evidence from studies in people that herbal remedies can treat, prevent or cure cancer". The use of herbal remedies is more prevalent in people with chronic diseases , such as cancer, diabetes , asthma , and end-stage kidney disease . Multiple factors such as gender, age, ethnicity, education and social class are also shown to have associations with

17732-551: The same meaning and are almost synonymous in most contexts. Terminology has shifted over time, reflecting the preferred branding of practitioners. For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and

17875-446: The same practices as integrative medicine. CAM is an abbreviation of the phrase complementary and alternative medicine . The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into

18018-581: The same time, in 1975, the American Medical Association , which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine. By 1983, mass marketing of "alternative medicine"

18161-832: The same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials . In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results. Cancer researcher Andrew J. Vickers has stated: Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label "unproven"

18304-649: The science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine. Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods. Examples include healing claims for non-vitamin supplements, fish oil , Omega-3 fatty acid , glucosamine , echinacea , flaxseed oil , and ginseng . Herbal medicine , or phytotherapy, includes not just

18447-555: The specialized agency of the United Nations (UN) that is concerned with international public health, published Quality control methods for medicinal plant materials in 1998 to support WHO Member States in establishing quality standards and specifications for herbal materials, within the overall context of quality assurance and control of herbal medicines. In the European Union (EU), herbal medicines are regulated under

18590-664: The surgery. Transplantation aside, high-intensity home hemodialysis appears to be associated with improved survival and a greater quality of life, when compared to the conventional three-times-a-week hemodialysis and peritoneal dialysis . People with ESKD are at increased overall risk for cancer. This risk is particularly high in younger people and gradually diminishes with age. Medical specialty professional organizations recommend that physicians do not perform routine cancer screening in people with limited life expectancies due to ESKD because evidence does not show that such tests lead to improved outcomes. In children, growth failure

18733-458: The treatment of sleep disorders. This means that it is unknown what is the best guidance to improve sleep quality in this population. Guidelines for referral to a nephrologist vary between countries. Most agree that nephrology referral is required by Stage 4 CKD (when eGFR/1.73m is less than 30 mL/min; or decreasing by more than 3 mL/min/year). It may also be useful at an earlier stage (e.g. CKD3) when urine albumin-to-creatinine ratio

18876-593: The two types of kidney replacement therapy ( dialysis or transplant ), is referred to as the end-stage kidney disease (ESKD). Hence, the start of the ESKD is practically the irreversible conclusion of the NDD-CKD. Even though the NDD-CKD status refers to the status of persons with earlier stages of CKD (stages 1 to 4), people with advanced stage of CKD (stage 5), who have not yet started kidney replacement therapy, are also referred to as NDD-CKD. Chronic kidney disease (CKD)

19019-510: The use of entheogens , in particular the San Pedro cactus ( Echinopsis pachanoi ) is still a vital component, and has been around for millennia. Some researchers trained in both Western and traditional Chinese medicine have attempted to deconstruct ancient medical texts in the light of modern science. In 1972, Tu Youyou , a pharmaceutical chemist and Nobel Prize winner , extracted the anti-malarial drug artemisinin from sweet wormwood ,

19162-672: The use of medicinal plants dates back to the Paleolithic age, approximately 60,000 years ago. Written evidence of herbal remedies dates back over 5,000 years to the Sumerians , who compiled lists of plants. Some ancient cultures wrote about plants and their medical uses in books called herbals . In ancient Egypt, herbs were mentioned in Egyptian medical papyri , depicted in tomb illustrations, or on rare occasions found in medical jars containing trace amounts of herbs. In ancient Egypt,

19305-480: The use of licorice where they recognize that this may be a risk. Black cohosh has been implicated in a case of liver failure. Few studies are available on the safety of herbs for pregnant women, and one study found that use of complementary and alternative medicines is associated with a 30% lower ongoing pregnancy and live birth rate during fertility treatment. Examples of herbal treatments with likely cause-effect relationships with adverse events include aconite (which

19448-518: The use of plant products, but may also include the use of animal and mineral products. It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents. The United States agency National Center for Complementary and Integrative Health (NCCIH) has created

19591-460: Was 15.8 cases per 10,000 dog years at risk. The mortality rate of CKD was 9.7 deaths per 10,000 dog years at risk. (Rates developed from a population of 600,000 insured Swedish dogs; one dog year at risk is one dog at risk for one year). The breeds with the highest rates were the Bernese mountain dog , miniature schnauzer and boxer . The Swedish elkhound , Siberian husky and Finnish spitz were

19734-527: Was diet. De Materia Medica , originally written in Greek by Pedanius Dioscorides ( c.  40  – c.  90 CE ) of Anazarbus , Cilicia , a physician and botanist, is one example of herbal writing used over centuries until the 1600s. The World Health Organization (WHO) estimates that 80 percent of the population of some Asian and African countries presently uses herbal medicine for some aspect of primary health care. Some prescription drugs have

19877-414: Was needed to reduce the risk of interaction of herbal medicines with prescription drugs , to implement clinical guidelines and prescription of herbal products, and to assure self-regulation for protection of public health and safety. In the United Kingdom, the training of herbalists is done by state-funded universities offering Bachelor of Science degrees in herbal medicine. In the United States, according to

20020-482: Was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Therapies are often framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope". The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science (though some alternative medicine promoters may use

20163-523: Was so pervasive that the British Medical Journal ( BMJ ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen". An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during

20306-496: Was the cause of 956,000 deaths globally in 2013, up from 409,000 deaths in 1990. The cause of chronic kidney disease is in some cases not known; it is referred to as chronic kidney disease of unknown aetiology (CKDu). As of 2020 a rapidly progressive chronic kidney disease, unexplained by diabetes and hypertension, had increased dramatically in prevalence over a few decades in several regions in Central America and Mexico,

20449-414: Was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. There are also reasons why a placebo treatment group may outperform a "no-treatment" group in

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