title: Association of betel nut chewing with chronic kidney disease: a retrospective 7-year study in Taiwan.
abstract: OBJECTIVE
  Only few studies have reported that betel nut (BN) chewing is independently associated with chronic kidney disease (CKD); however, the sample size was relatively small. This study was to explore further the association between BN chewing and CKD using a larger case series.
  
  
  METHODS
  We retrospectively reviewed the records of a health check-up program from 2003 to 2009. Laboratory tests, medical history and status of cigarette smoking, alcohol drinking and BN chewing were compared between CKD and non-CKD groups. We checked interaction effects between BN chewing and all other covariates, and conducted multivariate logistic regression analysis to explore the risk of CKD with BN chewing.
  
  
  RESULTS
  A total of 27 482 participants (15 491 females and 11 991 males, mean age 58.02 ± 11.85 years) were included in the study, of whom 4519 (16.4%) had CKD and 1608 (5.9%) chewed BN. CKD prevalence in the chewers was higher than in the non-chewers in all age groups per decade. BN chewing was significantly associated with CKD in overall subjects (odds ratio (OR) = 1.23, P = 0.027) and also in the male (OR = 1.23, P = 0.035), non-drinking (OR = 1.62, P = 0.000), non-diabetic (OR = 1.27, P = 0.021), and non-proteinuric groups (OR = 1.30, P = 0.013). This relationship was insignificant in female, drinking, diabetic and proteinuric groups.
  
  
  CONCLUSIONS
  The association between BN chewing and CKD seemed conditional on demographics, health behaviours, and underlying co-morbidities. This association should be interpreted cautiously.
authors: Division of Nephrology, Department of Internal Medicine, Chia-Yi Christian Hospital, Tainan, Taiwan.
authors: Yueh-Han
authors: YH
authors: Hsu
authors: Wen-Hsin
authors: WH
authors: Liu
authors: Wei
authors: W
authors: Chen
authors: Yi-Chun
authors: YC
authors: Kuo
authors: Chih-Yen
authors: CY
authors: Hsiao
authors: Peir-Haur
authors: PH
authors: Hung
authors: Ing-Ching
authors: IC
authors: Jong
authors: Pei-Chun
authors: PC
authors: Chiang
authors: Chih-Cheng
authors: CC
authors: Hsu
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001114:Areca / Q000009:adverse effects*; D001794:Blood Pressure; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology