Key elements for screening kidney deficiency pattern in Traditional Chinese and Korean Medicine: a systematic review and Delphi study.

Abstract

<h4>Objective</h4>To identify key elements for screening kidney deficiency pattern (KDP) through a systematic review and Delphi methodology to detect high-risk KDP groups.<h4>Methods</h4>We first conducted a systematic review to extract kidney system patterns and then performed four rounds of the Delphi. After the third round, two face-to-face consensus meetings were held to finalize the consensus. The English version of the KDP Screening Questionnaire (KDPScreenQ) was developed through agreement between a bilingual physician and the research team.<h4>Results</h4>A systematic review identified 35 studies that predominantly focused on KDP, KDP-<i>Yin</i>, and KDP-<i>Yang</i>. Twenty-two common symptoms were reported in five or more studies. A panel of ten experts, including specialists in internal medicine and diagnostics, participated in all four rounds of the Delphi process. The final KDPScreenQ comprises 20 key elements. Key elements for KDP include lassitude; weakness, and pain in the lumbar region and knee joints (four items); reduced libido or sexual dysfunction; tinnitus or deafness; urinary incontinence (two items); thinning and loss of hair; forgetfulness; loose teeth and weak gums. Key elements for KDP-<i>Yin</i> include heat sensation in the palms and feet; a sensation of heat and tightness in the chest (particularly in the afternoon); night sweats; and dry mouth. Key elements for KDP-<i>Yang</i> include aversion to cold; edema; early morning diarrhea; and loose stools.<h4>Conclusion</h4>The KDPScreenQ is a fundamental tool for standardizing KDP differentiation, serving both to screen patients with KDP and to track their long-term prognosis. This questionnaire will next be used in a prospective observational study to determine cut-off values.