Abstract：Objective：To observe the clinical effect of the four-in-one therapy on chronic kidney disease （CKD） in the peri-dialysis period. Methods：A total of 100 CKD patients in the pre-dialysis stage （peri-dialysis period） who visited the outpatient clinic or were hospitalized at Yangzhou Hospital of Traditional Chinese Medicine from January 2022 to December 2024 were selected and divided into the control group and the study group based on the random number table method，with 50 cases in each group. The control group received conventional western medicine treatment， and the study group was additionally treated with four-in-one therapy （oral administration of Baoshen Mixture， acupoint application， auricular point seed-pressing， and Chinese medicine retention enema）. Clinical efficacy， traditional Chinese medicine syndrome scores， kidney function indicators [blood urea nitrogen （BUN）， serum creatinine （SCr）， and estimated glomerular filtration rate （eGFR）]， and nutrition indicators [hemoglobin （Hb）， albumin （Alb）] were observed and compared between the two groups. Results：During treatment，two patients in the study group underwent hemodialysis due to disease progression，while six patients in the control group withdrew from conservative treatment due to worsening conditions （five patients received hemodialysis，one patient received peritoneal dialysis）. After treatment，the total effective rate was 66.00% （33/50） in the study group and 42.00% （21/50） in the control group， with a significant difference （P＜0.05）. The traditional Chinese medicine syndrome score in the study group was decreased when compared with that before treatment （P＜0.05） and was lower than that in the control group （P＜0.05）， while the control group showed no significant change in traditional Chinese medicine syndrome scores before and after treatment （P＞0.05）. After treatment， Hb levels in the two groups were increased when compared with those before treatment （P＜0.05）， with higher levels in the study group （P＜0.05）. The study group showed increased levels of Alb and eGFR compared to before treatment （P＜0.05），and the levels in the study group were higher than those in the control group （P＜0.05）. The study group showed decreased levels of BUN and SCr compared to before treatment （P＜0.05）， and the levels in the study group were lower than those in the control group （P＜0.05）. The control group only exhibited reduced SCr level （P＜0.05），with no significant changes in Alb， BUN，or eGFR before and after treatment （P＞0.05）. No adverse reactions were observed in either group. Conclusion： The four-in-one therapy can improve treatment efficacy， alleviate symptoms， and enhance kidney function and nutritional status in CKD patients in peri-dialysis period.