title: Relation of Complementary-Alternative Medicine use with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage.
abstract: OBJECTIVE
  Complementary and alternative medicine is a broad field of health including all health care practices and methods, and their accompanying theories and beliefs. In the present study, we aimed to examine the frequency of complementary-alternative medicine use, and its relation with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage.
  
  
  METHODS
  A total of 1053 predialysis patients; 518 female and 535 male, that were followed up with chronic kidney disease for at least 3 months were enrolled into the study. Demographic features, biochemical parameters and findings of physical examination were recorded. Their compliance to diet, and knowledge about disease were questioned. Beck depression inventory and questionnaire regarding complementary-alternative medicine use were performed.
  
  
  RESULTS
  The overall frequency of complementary-alternative medicine use was 40.3% . Total ratio of herbal products was 46%. Complementary-alternative medicine use was significantly more frequent in female or single patients, and patients that informed about chronic kidney disease or under strict diet (P = 0.007, P = 0.016, P = 0.02, P = 0.016, respectively). When glomerular filtration rate of participants were considered, complementary-alternative medicine use was similar in different stages of kidney disease. Depression was observed in 41.9% of patients and significantly frequent in patients with alternative method use (P = 0.002). Depression score was higher as creatinine increases and glomerular filtration rate decreases (P = 0.002; r = 0.093).
  
  
  CONCLUSIONS
  We determined that complementary-alternative medicine use gradually increases at predialysis stage as glomerular filtration rate decreases and there is a strict relation between complementary-alternative medicine use and depression or female gender. Disorder related stressors may lead to seeking of alternative methods.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Bennur
authors.initials: B
authors.lastname: Esen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet Engin
authors.initials: AE
authors.lastname: Atay
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Emel Saglam
authors.initials: ES
authors.lastname: Gokmen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ayten
authors.initials: A
authors.lastname: Karakoc
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Sari
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Samprie
authors.initials: S
authors.lastname: Sarisakal
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bursa Sevket Yılmaz Education and Research Hospital, Bursa, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Kahvecioglu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kayabasi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Bagcilar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Dede
authors.initials: D
authors.lastname: Sit
keywords: Chronic kidney disease; complementary-alternative medicine; depression; predialysis