Part 3 of 4 in the kidney series. Part 1 is what the TCM "kidney" governs; part 2 is what an aching back has to do with it; part 4 is when to see a doctor and what a consultation does.

The company screening report comes back with an arrow beside the creatinine. The same week, a parent hands over a packet labelled 「补肾」. Two questions, taken separately.

The short version

• The kidney items in an annual screening are two: a urine test for protein and a blood test for creatinine — part of the yearly screening the National Kidney Foundation of Malaysia recommends.
• Creatinine is a waste product from muscle activity, normally removed by the kidneys; the doctor uses it plus your age, race and gender to estimate the glomerular filtration rate — that is the Foundation.
• The NHS puts eGFR more concretely: the blood result is used to calculate how many millilitres of waste the kidneys should be able to filter in a minute.
• Registration answers "has this been through review"; it does not answer "which pattern is it for" — the word 「补肾」 on the packet does not say.
• For a packet labelled 「补肾」, look for the MAL number and the Meditag hologram the Ministry of Health requires, then check the current status at npra.gov.my — the printed number speaks only for the day it was printed.

First, the things that cannot wait

Persistent flank pain, particularly with fever — call 999 now, or go to the nearest hospital emergency department. The NHS's kidney infection page lists a high temperature and pain in the lower back or side among its symptoms, and states it can be serious if untreated.

Blood in the urine or a marked change in colour, persistently foamy urine that does not settle, swelling around the eyes or in the lower legs, a marked increase or decrease in how much you pass — see a doctor first. Blood in your pee must be checked out because it can be a sign of cancer — that is the NHS.

The reason for each, and the full list, are in part 4. TCM and Western medicine complement each other; it is not a choice between them.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

I. What the blood and urine tests measure

The National Kidney Foundation of Malaysia recommends an annual health screening that includes a urine test for protein, blood pressure, a blood test for glucose and a blood test for creatinine. Who counts as higher risk is part 4, which carries the Foundation's list.

Creatinine in the blood. Creatinine is a waste product from muscle activity, normally removed from the blood by the kidneys; when the kidneys are damaged, blood creatinine may build to a high level — that is the Foundation. A doctor uses it, plus your age, race and gender, to estimate the glomerular filtration rate (GFR); GFR tells how much kidney function you have.

The NHS puts the calculation more concretely: a doctor uses the blood test result to calculate how many millilitres of waste the kidneys should be able to filter in a minute — that calculation is the eGFR (estimated glomerular filtration rate).

Why creatinine: the Foundation writes that a build-up of creatinine in the blood indicates kidney function and the level of kidney impairment. That number is a yardstick for "how much filtering capacity is left", not for 「肾虚」.

Protein in the urine. When the kidneys are damaged, protein leaks into the urine; two positive tests over several weeks is called persistent protein in the urine, and is a sign of chronic kidney disease. The NHS urine test also checks the albumin:creatinine ratio (ACR) and whether there is blood or protein in the urine; alongside the eGFR it gives a more accurate picture of how well the kidneys are working.

So it is two tests, not one.

At what point the creatinine figure starts to move noticeably, none of these pages explains, and this article does not fill that in. Why these two tests are done on a schedule rather than when something feels wrong, with the NHS's reason, is part 4.

All of this is the doctor's work. A TCM consultation does not run these tests or read these figures; keep the report and show it at the consultation. If an item on it is abnormal, follow up as your doctor arranges.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

II. How to read a "kidney tonic" packet: one example

Suppose there is a packet labelled 「补肾」 in your hand. Read it from the packaging up, step by step.

1. Find the number. In Malaysia, registered medicines, traditional and proprietary Chinese medicines included, carry a registration number beginning with MAL and a Meditag hologram on the packaging; products and remedies of unknown origin, or with no registration number, sit outside that review. The format is "MAL" followed by 8 digits and a final letter; the example number on the Ministry of Health's page is MAL20125467T.

2. Read the last letter. It indicates the registration category — in the Ministry of Health's categories, T is natural products and traditional medicines, N is health supplements. Two packets both labelled 「补肾」 may be registered one as a traditional medicine, the other as a health supplement — the letter tells you which category it was submitted under.

3. Check the current status. Go to Product Search on npra.gov.my and search by product name or registration number; for a registered product, the status is displayed — that is the route the Ministry of Health's page gives. The "NPRA Product Status" app does the same. Why check when there is already a number: in a 2019 press release, the NPRA reported a traditional product found to contain sildenafil and tadalafil, and its registration was cancelled. The number printed on the packet speaks for the day it was printed; the search result speaks for today.

4. Verify the Meditag label. After checking the number, the Ministry of Health advises checking the hologram label's validity through a pharmacist at a nearby hospital, clinic or pharmacy.

5. Ask "tonify which pattern". Registration answers "has this been through review"; it does not answer "which pattern is it for". The word 「补肾」 on the packet does not say which of the WHO standard's kidney patterns it corresponds to; whether to tonify, and what, is the practitioner's call after seeing the whole picture.

6. If you take prescribed medication, tell your doctor and your practitioner first, and never stop a prescription on your own.

These steps read a packet, not a person. At the end you have "what this is, what review it has been through, and who to ask" — not "what happens if I take it". Whether to take it, and which situations need asking first, are in part 4.

The words in this part

• Creatinine (肌酸酐) — a waste product from muscle activity, normally removed from the blood by the kidneys (the Foundation's description). A line item on a blood test report.
• eGFR (estimated glomerular filtration rate) — the figure a doctor calculates from the blood test: how many millilitres of waste the kidneys should be able to filter in a minute. The NHS's wording.
• Persistent protein in the urine — protein found on two tests over several weeks. The Foundation says this is a sign of chronic kidney disease.
• MAL registration number — "MAL" plus 8 digits plus a category letter, printed on registered medicines (the Ministry of Health's description). T is natural products and traditional medicines, N is health supplements.
• Meditag hologram — the hologram on registered medicine packaging. The Ministry of Health advises having a pharmacist check it is valid.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

Frequently asked

My blood test is normal — can I still have "kidney deficiency"? Possibly, because the two measure different things. The blood test looks at the kidney as an organ; 「肾虚证」 is a pattern name for the functional system called 「肾」 in TCM theory, reached by a practitioner's assessment. A normal report does not mean the practitioner will say 「肾虚」, and nor does an abnormal one. Bring it all the same, because it decides the see-a-doctor-first half — see part 4.

The other three parts

• Part 1: What "kidney deficiency" actually means — what the TCM "kidney" governs
• Part 2: Is an aching back kidney deficiency? — the routes the theory lists, and the organ on the report
• Part 4: When to see a doctor first, and what the practitioner does at a consultation

👉 If you are not sure "how to explain this packet and this report to a practitioner", you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you; if what worries you is the organ itself, or if anything in "First, the things that cannot wait" above or in part 4 applies, see a doctor for tests first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• National Kidney Foundation of Malaysia, Common Kidney Disease — https://nkf.org.my/facts-about-kidneys/common-kidney-disease/
• National Kidney Foundation of Malaysia, Facts About Kidneys — https://nkf.org.my/facts-about-kidneys/
• NHS, Chronic kidney disease — Diagnosis, page last reviewed 22 March 2023 — https://www.nhs.uk/conditions/kidney-disease/diagnosis/
• Ministry of Health Malaysia, Pharmaceutical Services Programme FAQ, How to identify medicines that are registered with MOH — https://pharmacy.moh.gov.my/en/faq/how-identify-medicines-are-registered-moh.html
• NPRA / Ministry of Health, Kenyataan Akhbar KPK 18 Mac 2019 – Produk Tradisional Nan Bao Capsule Dikesan Mengandungi Racun Berjadual Sildenafil Dan Tadalafil — https://npra.gov.my/index.php/en/component/content/article/412-english/press-release/press-release-2019/2066-kenyataan-akhbar-kpk-18-mac-2019-produk-tradisional-nan-bao-capsule-dikesan-mengandungi-racun-berjadual-sildenafil-dan-tadalafil.html
• World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 — https://www.who.int/publications/i/item/9789240042322
• NHS, Blood in urine, page last reviewed 25 September 2026 — https://www.nhs.uk/symptoms/blood-in-urine/
• NHS, Kidney infection, page last reviewed 13 February 2025 — https://www.nhs.uk/conditions/kidney-infection/

本文是「肾虚与肾脏」系列的第 3 篇，共 4 篇。第 1 篇讲中医的「肾」管什么，第 2 篇讲腰酸跟「肾」的关系，第 4 篇讲什么时候要先看医生、看诊会做什么。

公司体检报告拿回来，肌酸酐旁边有个箭头；同一个星期，长辈递来一包写着「补肾」的丸药。这是两个问题，这一篇分开处理。

一分钟看完

• 年度体检的肾脏项目是两项：验尿看蛋白、验血看肌酸酐。这是马来西亚全国肾脏基金会建议的年度筛查内容之一。
• 肌酸酐是肌肉活动产生的废物，正常由肾脏清除；医生用它加上年龄、种族与性别，估算肾小球过滤率——这是基金会的说明。
• NHS 把 eGFR 说得更具体：用验血结果计算肾脏每分钟应能过滤多少毫升的废物。
• 注册回答的是「这个产品有没有经过审查」，不回答「它对应哪一个证」——包装上的「补肾」两个字没有说。
• 一包写着「补肾」的药，先看卫生部要求的 MAL 编号与 Meditag 标签，再到 npra.gov.my 查现在的状态——印在包装上的编号只说得上印刷那天。

先说不能等的几件事

腰部持续疼痛，尤其伴随发烧——请立刻拨打 999，或前往最近的医院急诊部。NHS 的肾脏感染页写明，发烧与腰侧或下背的疼痛都在肾脏感染的症状里，不治疗可能变得严重。

小便带血或颜色明显改变，小便有大量泡沫久久不散，眼睑或下肢水肿，小便量明显变多或变少——请先就医。尿里带血一定要检查，因为它可能是癌症的征兆——这是 NHS 写的。

每一项的理由与完整清单，见第 4 篇。中医与西医是互相补位的关系，不是二选一。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

一、验血与验尿在量什么

马来西亚全国肾脏基金会建议每年做一次健康筛查，项目包括：验尿看蛋白、量血压、验血看血糖、验血看肌酸酐。哪些人属于风险较高的一群，第 4 篇有基金会列出的名单。

血里的肌酸酐。 肌酸酐是肌肉活动产生的废物，正常由肾脏从血液中清除；肾脏受损时，血液中的肌酸酐可能升高——这是基金会的说明。医生会用这个数值，加上年龄、种族与性别，估算肾小球过滤率（GFR）；GFR 说明的是肾功能还有多少。

NHS 把这个计算说得更具体：医生用验血的结果，计算肾脏每分钟应能过滤多少毫升的废物——这个计算结果就是 eGFR（估算肾小球过滤率）。

为什么看的是肌酸酐：基金会写道，血液中肌酸酐的堆积，可以指示肾功能与受损的程度。换句话说，那个数字是一把量「还剩多少过滤能力」的尺，不是量「肾虚」的尺。

尿里的蛋白。 肾脏受损时，蛋白会漏进尿液；几个星期内两次验出蛋白，称为持续性蛋白尿，是慢性肾脏病的一个征兆。NHS 的验尿项目还包括尿中白蛋白与肌酸酐的比值（ACR），以及尿里有没有血或蛋白；配合 eGFR，验尿能让「肾脏运作得怎么样」这幅图更准确。

所以是两项检验，不是一项。

至于肌酸酐的数字要到什么程度才会明显变化，这几页都没有说明，本文也不替它们补。为什么这两项要定期查、而不是等有感觉才查，第 4 篇有 NHS 给的理由。

这些都是医生的工作。中医问诊不做这些检验，也不解读这些数字；报告请留着，看诊时一并出示。若报告上有异常项目，请按医生的安排复诊。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

二、一包「补肾」丸，怎么读：一个例子

假设手上有一包写着「补肾」的丸药。从包装读起，一步一步。

一、找编号。 在马来西亚，注册药品（包括传统药与中成药）的包装上有以 MAL 开头的注册编号与 Meditag 防伪标签；来源不明、没有注册编号的产品与偏方，不在这个审查范围内。编号的格式是「MAL」加 8 位数字、再加一个字母；卫生部页面上的示例编号是 MAL20125467T。

二、看最后那个字母。 它说明注册类别——卫生部的分类里，T 是天然产品／传统药，N 是保健品。两包同样写着「补肾」的东西，可能一包以传统药注册、另一包以保健品注册——字母告诉您它是以哪一类送审的。

三、查现在的状态。 到 npra.gov.my 的 Product Search，用产品名或注册编号查询，注册产品会显示注册状态——这是卫生部页面给的查法；也可用「NPRA Product Status」应用程式。有编号为什么还要查：NPRA 在 2019 年的一则新闻稿中，一款传统产品被检出含有西地那非（sildenafil）与他达拉非（tadalafil），注册被取消。印在包装上的编号说的是印刷时的状态，查询结果说的是现在的状态。

四、核对 Meditag 标签。 查完编号后，卫生部建议到附近的医院、诊所或药剂行，请药剂师核对防伪标签的真伪。

五、问「补哪一个证」。 注册回答的是「这个产品有没有经过审查」，不回答「它对应哪一个证」。包装上的「补肾」两个字，没有说它对应世卫标准里列出的哪一个肾证；要不要补、补什么，是医师看过整体之后的事。

六、正在吃医生开的药的，先告诉医生与医师，切勿自行停药。

这几步读的是一包药，不是读某个人。走完之后得到的是「这包东西是什么、经过什么审查、该问谁」，不是「吃了会怎样」。要不要吃、什么情况要先问，见第 4 篇。

这篇出现的几个词

• 肌酸酐（creatinine）——肌肉活动产生的废物，正常由肾脏从血液中清除（基金会的说明）。验血报告上的一个项目。
• eGFR（估算肾小球过滤率）——医生用验血结果算出的数值：肾脏每分钟应能过滤多少毫升的废物。NHS 的说法。
• 持续性蛋白尿——几个星期内两次验出尿中有蛋白。基金会说这是慢性肾脏病的一个征兆。
• MAL 注册编号——「MAL」加 8 位数字再加一个类别字母，印在注册药品包装上（卫生部的说明）。T 是天然产品／传统药，N 是保健品。
• Meditag 防伪标签——注册药品包装上的全息标签。卫生部建议请药剂师核对真伪。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

常见问题

验血正常，还会「肾虚」吗？ 可能会，因为两者量的不是同一件事。验血看的是肾脏这个器官；「肾虚证」是中医理论中「肾」这个功能系统的一个证名，由医师辨证。报告正常不等于医师会说「肾虚」，报告异常也一样。报告仍然要带来，因为它决定的是先看医生那一半——见第 4 篇。

这个系列的另外三篇

• 第 1 篇：「肾虚」到底是什么——中医理论里的「肾」管什么
• 第 2 篇：腰酸就是肾虚吗——理论列的几条路，和报告上的那两颗器官
• 第 4 篇：什么时候要先看医生，看诊时医师会做什么

👉 如果您不确定「这包补肾丸、这张报告，该怎么说给医师听」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估；若您担心的是肾脏本身，或有本文「先说不能等的几件事」与第 4 篇列出的情况，请先就医做检查。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 马来西亚全国肾脏基金会，Common Kidney Disease — https://nkf.org.my/facts-about-kidneys/common-kidney-disease/
• 马来西亚全国肾脏基金会，Facts About Kidneys — https://nkf.org.my/facts-about-kidneys/
• NHS，Chronic kidney disease — Diagnosis，页面最后审阅 2023 年 3 月 22 日 — https://www.nhs.uk/conditions/kidney-disease/diagnosis/
• 马来西亚卫生部药剂服务计划常见问题，How to identify medicines that are registered with MOH — https://pharmacy.moh.gov.my/en/faq/how-identify-medicines-are-registered-moh.html
• NPRA／卫生部，Kenyataan Akhbar KPK 18 Mac 2019 – Produk Tradisional Nan Bao Capsule Dikesan Mengandungi Racun Berjadual Sildenafil Dan Tadalafil — https://npra.gov.my/index.php/en/component/content/article/412-english/press-release/press-release-2019/2066-kenyataan-akhbar-kpk-18-mac-2019-produk-tradisional-nan-bao-capsule-dikesan-mengandungi-racun-berjadual-sildenafil-dan-tadalafil.html
• 世界卫生组织，WHO international standard terminologies on traditional Chinese medicine，2022 — https://www.who.int/publications/i/item/9789240042322
• NHS，Blood in urine，页面最后审阅 2026 年 9 月 25 日 — https://www.nhs.uk/symptoms/blood-in-urine/
• NHS，Kidney infection，页面最后审阅 2025 年 2 月 13 日 — https://www.nhs.uk/conditions/kidney-infection/