The pattern of kidney yang deficiency with water retention refers to the symptoms and signs caused by the decline of kidney yang deficiency, the dysfunction of bladder qi transformation, and the retention of water-dampness. It is mostly caused by prolonged illness and maladjustment, or constitutional weakness leading to the depletion of kidney yang.

The main clinical manifestations include: scanty urine and body swelling, especially below the waist, which is indented upon pressing, fear of cold, cold limbs, soreness and coldness in the lower back and knees, abdominal distension and fullness, a swollen and tender tongue, pale tongue texture with tooth marks, white and slippery tongue coating, and a deep and slow pulse.

The pattern of kidney yang deficiency with water retention is commonly seen in diseases such as "edema" and "phlegm-fluid retention."

This syndrome should usually be differentiated from the "kidney-yang deficiency pattern."

bubble_chart Differentiation and Treatment

The pattern of kidney yang deficiency with water retention appears in diseases with edema and phlegm fluid retention diseases, with similar pathological characteristics and clinical manifestations. The difference lies in that,

1. in diseases with edema, it is characterized by generalized edema, especially severe swelling below the waist, pitting edema upon pressure, and a swollen and tender tongue. The disease is caused by kidney yang deficiency leading to failure in qi transformation, resulting in water-dampness flooding. Treatment should focus on warming the kidney and yang, warming yang qi to promote diuresis, using the formula True Warrior Decoction (from the "Treatise on Cold Damage Diseases");
2. in phlegm fluid retention diseases, it is characterized by fluid retention in the intestines and stomach, fullness in the chest and hypochondrium, splashing sounds in the epigastrium, vomiting clear water and phlegm, lower abdominal tension, pulsations below the navel, difficulty in urination, a gray and greasy tongue coating, and a wiry and slippery pulse. It is mostly caused by kidney yang deficiency and failure in transformation, leading to water retention in the intestines and stomach. Treatment should focus on warming yang and excreting water, using the formula Golden Chamber Kidney Qi Pill (from Jingui Yaolue) combined with Five Ingredients with Poria Powder (from the "Treatise on Cold Damage Diseases").

The pattern of kidney yang deficiency with water retention is commonly seen in elderly individuals with declining health, while in children, it is often caused by congenital insufficiency of kidney qi and improper postnatal care. In the course of disease progression, this syndrome can manifest in two scenarios: one is water pathogen attacking the heart, caused by kidney yang deficiency leading to water rising and qi counterflow, accumulating in the chest and obstructing heart yang, resulting in symptoms such as palpitations, shortness of breath, and rapid pulse; the other is water-cold attacking the lung, caused by kidney yang deficiency leading to water-dampness retention, with water-cold rising qi invading the lung, causing lung qi to fail in dispersion and descent, resulting in symptoms such as cough, panting, profuse thin white phlegm, and inability to lie flat.

bubble_chart Differentiation of Similar Patterns

1. Kidney yang deficiency and pattern of kidney yang deficiency with water retention: The kidneys govern water, control qi transformation, and regulate urination and defecation. If due to overstrain and internal damage, excessive sexual activity, or prolonged illness leading to the depletion of kidney qi, kidney yang gradually declines. Kidney deficiency then leads to impaired opening and closing, abnormal bladder qi transformation, and the accumulation of water, resulting in the pattern of kidney yang deficiency with water retention. Although the pathological nature of kidney-yang deficiency pattern and pattern of kidney yang deficiency with water retention share similarities, the former is a purely deficient condition, while the latter is a deficiency mixed with excess, with varying degrees of severity. The former is primarily characterized by insufficient primordial yang, impaired warming function, and weakened sexual function; the latter is mainly manifested by generalized edema, particularly severe in the lower back, pitting edema upon pressure, and a swollen, tender tongue, indicating water-dampness overflow.

bubble_chart Documentation

1. Yimen Falu‧Edema: "The kidneys are the gate of the stomach. The kidneys govern opening and closing. When kidney qi follows yang, it opens; when yang is excessive, the gate opens wide, and water flows directly downward, leading to dissipation. When kidney qi follows yin, it closes; when yin is excessive, the gate remains closed, and water cannot pass, resulting in swelling."