Project Affiliation: Traditional Chinese Medicine Nephrology Field. Main Content: Renal fibrosis is a common pathway for various chronic kidney diseases (CKD) to progress to end-stage renal failure (ESRD). In recent years, the incidence and hospitalization rates of CKD patients in China, especially ESRD patients, have significantly increased, posing a serious threat to human health and life. Therefore, the prevention and treatment of renal fibrosis is an important task facing the clinical community. Traditional Chinese medicine (TCM) has unique advantages in the treatment of renal fibrosis both theoretically and practically. This research group, based on the TCM theory of 'Qi and Blood Support,' focuses on ischemia and hypoxia as key initiating factors for promoting renal fibrosis. Drawing on the connection between ischemia and hypoxia-induced renal fibrosis and 'Qi deficiency, Blood deficiency, Blood stasis,' after more than 20 years of clinical and basic experimental verification, they have developed a formula that tonifies Qi and Blood. The effective compound prescription for removing blood stasis and eliminating turbidity, RenShai II formula, has shown a positive effect in the prevention and treatment of renal fibrosis. Through a clinical study on 93 patients with CKD stage 3-4, the research group found that the disease efficacy of RenShai II formula increased by 43.00% compared to the integrated treatment group (91.00% vs 48.00%), with the ability to improve GFR, reduce blood uric acid, regulate calcium and phosphorus metabolism, and delay the progression of CKD; the efficacy of traditional Chinese medicine syndromes increased by 41.00% (91.00% vs 50.00%). The research results were appraised and accepted by experts organized by the Municipal Science and Technology Commission on November 22, 2011. The comparative experiment study of RenShai II formula with Angiotensin II inhibitor showed that the mechanism of action of RenShai II formula is as follows: ① Reduce the oxygen consumption (QO2/TNa) in the residual kidney of 5/6 nephrectomy chronic renal failure rats. Improves renal blood flow (RBF), significantly reduces SCr and BUN, and markedly increases CCr. ② Inhibits the excessive expression of AngII, HIF-1α protein and gene in renal tissue, as well as the expression of TGF-β1, CTGF, COX-2 mRNA, and upregulates the protein and gene expression of nNOS. ③ Pathological results show that it can alleviate renal fibrosis in rats with chronic renal failure. ④ Immunohistochemical analysis shows that it can inhibit the expression of fibronectin (FN) and laminin (LN). Innovation points and characteristics: (1) It is the first to verify in China that an increase in residual kidney oxygen consumption (QO2/TNa) and a decrease in renal blood flow are closely related to renal function damage in models of chronic renal failure. (2) The anti-renal fibrosis effect of Kidney Failure Formula II is related to the improvement of renal oxygen consumption and renal blood flow, which has not been reported in China yet. The first use of an ultrasonic blood flow meter in China to detect renal blood flow and calculate renal oxygen consumption (QO2/TNa) provides a new experimental method to verify the effect of renal oxygen consumption, which has not been reported in domestic literature. (4) For the first time, it interprets the relationship between renal fibrosis and the traditional Chinese medicine theory of 'Qi and Blood Support each other', revealing an important clue for the anti-renal fibrosis effect of this formula, enriching and developing the application of the traditional Chinese medicine theory 'Qi is the commander of Blood, and Blood is the mother of Qi' in the treatment of chronic kidney disease. In summary, Kidney Failure Formula No. II has a significant therapeutic effect on improving renal function in chronic renal failure. By exploring its anti-renal fibrosis mechanism from the perspective of renal oxygen consumption, it interprets the modern scientific connotation of the traditional Chinese medicine theory of 'Qi and Blood Support each other', enriches and develops the basic theories of chronic kidney disease, and provides new ideas and methods for the prevention and treatment of CKD with traditional Chinese medicine. Application and Promotion: Published 30 papers, including 28 in core journals, 2 in SCI, 4 included in PubMed, with 23 citations in SCI and 213 citations in core journals (including 180 citations by others). Granted 1 invention patent, which won the Shanghai Excellent Invention Gold Award. Trained 15 graduate students. The research results have been promoted and used in affiliated hospitals of Shanghai University of Traditional Chinese Medicine such as Shuguang Hospital, Longhua Hospital, Yueyang Integrated Traditional Chinese and Western Medicine Hospital, Putuo Hospital, Shanghai Traditional Chinese Medicine Hospital, the Seventh People's Hospital, Pudong New District Traditional Chinese Medicine Hospital, etc., generating good social impact and economic benefits.