This 65 year-old-male who has past history of poor-controlled Type II DM and hypertension diagnosed chronic kidney disease, stage V, with refractory edema. He suffered from bilateral lower limbs pitting edema, grade 4, blurred vision, fatigue and anemia. Diuretics can't relieve his refractory edema lead to poor quality of life. Thus, he came to acupuncture-OPD for help. The acupoints included Yin ling quan (SP9), San yin chiao (SP6), Shuifen (CV 9), Shuidao (ST28). After receiving one-month acupuncture and moxibustion treatment, the patient presented significant improvement in edema. We present this case to provide primary care physicians with reference for treating a CKD patient with lower leg edema. However, this issue is still controversial and the duration of acupuncture treatment is not established.