Remission Induced by Shichimotsukokato in an Older Adult With Nephrotic Syndrome Secondary to Diabetic Kidney Disease: A Case Report

Nephrotic syndrome is a major renal disease characterized by massive proteinuria, hypoalbuminemia, systemic edema, and hyperlipidemia. Diabetic kidney disease (DKD) can induce secondary nephrotic syndrome, which is often challenging to manage with conventional treatments such as renin-angiotensin system inhibitors and diuretics. We present a case of a 90-year-old woman with DKD who developed nephrotic syndrome secondary to DKD that was refractory to standard treatments. Upon administration of shichimotsukokato (SCMKT), a representative Kampo formula created in Japan, there was a marked reduction in the proteinuria and an improvement in the serum albumin concentration, leading to remission of the nephrotic syndrome and enabling tapering of the renin-angiotensin system inhibitor and diuretics. This case suggests that SCMKT may be a candidate therapeutic option for nephrotic syndrome in patients with DKD. Further studies are needed to clarify the clinical benefits and pharmacological mechanisms of SCMKT in DKD.