The Donguibogam's view of the kidneys as the 'source of life' aligns remarkably well with modern medicine. In modern medicine, chronic kidney disease refers to a state where kidney function gradually declines, and rather than merely filtering waste products, it exerts a massive influence on overall bodily health. The kidney is a vital organ that filters waste from the blood, regulates fluid balance, maintains blood pressure, and produces erythropoietin, a hormone that aids erythropoiesis, as well as active vitamin D, which is essential for bone health.
As chronic kidney disease progresses, multiple bodily systems gradually break down, akin to the depletion of essence described in Donguibogam; muscle weakness and extreme fatigue are among the most distressing symptoms experienced by patients. Let us look closely at these phenomena scientifically.
First is uremic myopathy. When kidney function declines, uremic toxins accumulate in the blood, and these toxins directly damage muscle cells, hinder muscle protein synthesis, and accelerate proteolysis. You can understand this as being filled with toxic substances that dissolve muscle. Furthermore, chronic inflammation and vitamin D deficiency accelerate muscle loss.
Second, anemia accompanies this condition. Healthy kidneys secrete erythropoietin to stimulate erythropoiesis, but weakened kidney function reduces the production of this hormone, readily causing anemia. When blood cannot transport sufficient oxygen, all organs including muscles suffer from oxygen deficiency, ultimately leading to extreme fatigue and lethargy. This is precisely why one feels short of breath and strained with just slight exertion.
Third is electrolyte imbalance and acid-base disturbances. The kidneys maintain electrolyte balance for potassium, calcium, and phosphate, and regulate blood acidity. When kidney hypofunction occurs, this balance is disrupted, which can cause muscle spasms or weakness, and chronic metabolic acidosis further accelerates muscle proteolysis.
Fourth is protein-energy wasting (PEW). Patients with chronic kidney disease often suffer from poor nutritional intake due to loss of appetite, vomiting, and chronic inflammation, leading to excessive consumption of body protein and energy. This directly leads to decreased muscle mass and systemic weakness.
Thus, chronic kidney disease is not merely an isolated problem of the kidneys, but a complex condition that disrupts the entire balance of our body, inflicting diverse suffering such as lethargy, muscle weakness, fatigue, and anemia. It reminds us once again of the preciousness of the kidneys, which Donguibogam called the 'source of life'.
