Long-term integrative personalized medicine care in end-stage renal disease and stroke: A CARE-compliant case report

Rationale: End-stage renal disease (ESRD) is characterized by severely impaired renal function that necessitates dialysis or kidney transplantation for patient survival. Integrative Personalized Medicine Care (IPMC), which integrates conventional therapies with Traditional Korean Medicine, has been applied as a complementary approach to address ESRD and its associated complications through a holistic and individualized care model. To our knowledge, this is among the first documented cases evaluating the long-term safety and efficacy of IPMC in a patient with ESRD complicated by intracerebral hemorrhage (ICH). Patient concerns: An 80-year-old male patient undergoing dialysis for ESRD since 2021 experienced a left ICH in September 2022. Poststroke, he presented with clinical challenges including uncontrolled hypertension, nutritional imbalance, and persistent constipation. Diagnoses: The patient was diagnosed with ESRD requiring regular dialysis and later suffered from a left ICH, which further complicated his clinical condition. Interventions: The patient received IPMC at Kyung Hee University Hospital, integrating conventional treatments with individualized herbal medicine and acupuncture. Herbal prescriptions were continuously adjusted in response to clinical status, laboratory markers, and interactions with concurrent medications. Outcomes: Renal function parameters stabilized during the treatment period, and clinical control of comorbidities improved. Nutritional status improved, blood pressure was effectively managed, and symptoms of constipation were resolved. Subjective enhancements in quality of life were also reported. Importantly, no hepatic or renal toxicity was observed despite the long-term administration of herbal medicines, indicating favorable safety under medical supervision. Lessons: This case demonstrates the clinical feasibility and safety of IPMC in managing ESRD patients with concurrent complications such as ICH. Long-term integration of Traditional Korean Medicine and conventional therapies may provide adjunctive clinical benefits without compromising safety. IPMC may serve as a viable supportive strategy for addressing multifactorial challenges in ESRD management. Further large-scale cohort studies are warranted to strengthen the evidence base for this integrative treatment model.