Increased risk of chronic kidney disease among users of non-prescribed Chinese herbal medicine in Taiwan.
BACKGROUND
Taiwan has the highest incidence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. Chinese herbal medicine (CHM) has been linked to CKD/ESRD in Taiwan. The specific effects and frequency of CHM on the risk of CKD are unknown.


METHODS
A hospital-based case-control study was performed from August 2006 through December 2009. The cases were consecutive nephrology outpatients 20years of age or older, with a first-time diagnosis of CKD, and without cancer or pre-existing renal disease. The controls were randomly selected outpatients that did not have CKD and were matched 1:1 to cases for age, gender and date of outpatient visit.


RESULTS
Four hundred and twenty-four patients were recruited. Among 212 cases, 23.6% took non-prescribed CHM, compared to 6.6% among the controls (p<0.001). Multivariate analysis showed that illiteracy [odds ratio (OR) 6.3, 95% confidence interval (CI) 2.4-16.6], hypertension (OR 5.4, 95% CI 2.9-9.8) and occasional use of non-prescribed CHM (OR 6.2, 95% CI 1.8-21.6) were positively associated with CKD, whereas regular exercise was inversely associated with CKD (OR 0.5, 95% CI 0.3-0.9).


CONCLUSIONS
Occasional use of non-prescribed CHM was associated with the risk of CKD in Taiwan.
Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Chuan-Fa
CF
Hsieh
Song-Lih
SL
Huang
Chien-Lung
CL
Chen
Wei-Ta
WT
Chen
Huan-Cheng
HC
Chang
Ming-Ling
ML
Wu
Chen-Chang
CC
Yang
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D015444:Exercise / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000188:drug therapy* / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
D004365:Drugs, Chinese Herbal