Hypoxia is an important mediator and key pathological link in renal fibrosis, permeating the entire process of chronic kidney disease (CKD) nephropathy. Based on the physiological and pathological changes of CKD, as well as the 'Qi and Blood Relationship Theory' in traditional Chinese medicine, 'Qi deficiency, blood deficiency, and blood stasis' are representative of chronic renal failure (CRF) nephropathy. The research team has focused on the mechanism of action of Kidney II formula, which tonifies Qi and blood, resolves stasis, and relieves turbidity, in anti-renal fibrosis, achieving the following main technological innovations: 1. The close relationship between renal oxygen consumption and kidney function in chronic renal failure nephropathy was discovered: the residual renal oxygen consumption (QO2/TNa) increased in the 5/6 (A/I) renal failure model, the oxygen partial pressure in renal vein (RVpO2) significantly decreased, SCr and BUN were markedly elevated, and CCr was significantly reduced. 2. The discovery of hypoxia-induced chronic renal failure, kidney fibrosis, and the pathological mechanisms of abnormal signaling pathways such as high expression of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), cyclooxygenase-2 (COX-2) mRNA, AngII, and HIF-1α protein; and low expression of nNOS protein. 3. The identification of the multi-target, multi-pathway integrative anti-fibrotic mechanism of Kidney Failure Formula II: inhibition of TGF-β1 and CTGF mRNA expression in kidney tissue; downregulation of COX-2, AngII, HIF-1α mRNA and protein expression, and upregulation of nNOS mRNA and protein expression; reduction of oxygen consumption within the kidneys, improvement of RVpO2, and enhancement of the microenvironmental oxygenation of kidney tissue. 4. This project utilizes a new technology of ultrasonic blood flow meter to detect renal blood flow, and through the i-STAT blood gas analyzer, it separately detects the O2Hb% and PO2 in the blood gases of the renal vein and abdominal aorta, analyzes the oxygen consumption within the kidney, providing a new method for accurately verifying the effect of 'Kidney Failure Formula No. II' on improving renal oxygen consumption, which has not been reported in domestic literature. 5. It was found that Kidney Failure Formula No. II can improve the efficacy of disease and traditional Chinese medicine syndromes in patients with CKD stage 3-4, reduce blood creatinine and uric acid levels, improve GFR, increase blood calcium, decrease blood phosphorus, and improve the staging of CKD, which is of significant guiding significance and application value for enhancing clinical efficacy. 6. It was discovered that hypoxia leads to close connection between renal fibrosis and the traditional Chinese medical theory of 'Qi and Blood Correlation'. Interpret the scientific connotations of traditional Chinese medicine theory that 'Qi and Blood support each other' and 'Qi is the commander of blood' and 'Blood is the mother of Qi'. Characteristics: Through basic and clinical research, repeatedly demonstrate the unique therapeutic effect of Kidney Failure II prescription in improving renal function in chronic kidney failure, explore the integrated action mechanism of Kidney Failure II prescription in anti-renal fibrosis from multiple pathways and targets, verify the characteristics of traditional Chinese medicine in preventing and treating renal fibrosis with the method of 'Tonifying Qi, Nourishing Blood, and Removing Stasis', interpret the scientific connotations of hypoxia leading to renal fibrosis and the traditional Chinese medicine theory of 'Qi and Blood support each other' and 'Qi and Blood are interdependent', reveal important clues for intervention in renal fibrosis with traditional Chinese medicine, and provide new ideas and methods for theoretical innovation and prevention and treatment of CKD-related renal fibrosis. Application promotion: Obtained 1 national invention patent. The patent won the 24th Shanghai Excellent Invention Gold Award, received one Ministry of Education Achievement Award, four funded projects, published 42 papers, including one SCI-indexed paper and two PubMed-indexed papers. One SCI paper was cited 13 times, and 14 domestic papers were cited 148 times, with 135 citations being from other papers. The research team participated in eight national kidney disease academic conferences, trained four doctoral students and ten master's students. The Kidney Failure II prescription has now been promoted and used at Longhua Hospital, Yueyang Hospital, Shanghai Traditional Chinese Medicine Hospital, Putuo Affiliated Hospital of Shanghai University of Traditional Chinese Medicine, Seventh People's Hospital of Shanghai, Pudong New Area Traditional Chinese Medicine Hospital, etc., laying a solid foundation for expanding the clinical application range of traditional Chinese medicine in the prevention and treatment of CKD, and generating significant social impact and economic benefits.