Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study
Background: Chronic kidney disease (CKD) has become a worldwide burden due to the high co-morbidity and mortality. Diabetic nephropathy (DN) is one of the leading causes of CKD, and pre-dialysis is one of the most critical stages before the end-stage renal disease (ESRD). Although Chinese herbal med...
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Frontiers Media S.A.
2021-02-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.616522/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jenny Chun-Ling Guo Heng-Chih Pan Heng-Chih Pan Bo-Yan Yeh Yen Chu Lu Jiun-Liang Chen Jiun-Liang Chen Ching-Wei Yang Ching-Wei Yang Yu-Chun Chen Yi-Hsuan Lin Yi-Hsuan Lin Hsing-Yu Chen Hsing-Yu Chen Hsing-Yu Chen |
spellingShingle |
Jenny Chun-Ling Guo Heng-Chih Pan Heng-Chih Pan Bo-Yan Yeh Yen Chu Lu Jiun-Liang Chen Jiun-Liang Chen Ching-Wei Yang Ching-Wei Yang Yu-Chun Chen Yi-Hsuan Lin Yi-Hsuan Lin Hsing-Yu Chen Hsing-Yu Chen Hsing-Yu Chen Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study Frontiers in Pharmacology Chinese herbal medicine diabetic nephropathy end-stage renal disease mortality network analysis pre-dialysis |
author_facet |
Jenny Chun-Ling Guo Heng-Chih Pan Heng-Chih Pan Bo-Yan Yeh Yen Chu Lu Jiun-Liang Chen Jiun-Liang Chen Ching-Wei Yang Ching-Wei Yang Yu-Chun Chen Yi-Hsuan Lin Yi-Hsuan Lin Hsing-Yu Chen Hsing-Yu Chen Hsing-Yu Chen |
author_sort |
Jenny Chun-Ling Guo |
title |
Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study |
title_short |
Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study |
title_full |
Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study |
title_fullStr |
Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study |
title_full_unstemmed |
Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study |
title_sort |
associations between using chinese herbal medicine and long-term outcome among pre-dialysis diabetic nephropathy patients: a retrospective population-based cohort study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pharmacology |
issn |
1663-9812 |
publishDate |
2021-02-01 |
description |
Background: Chronic kidney disease (CKD) has become a worldwide burden due to the high co-morbidity and mortality. Diabetic nephropathy (DN) is one of the leading causes of CKD, and pre-dialysis is one of the most critical stages before the end-stage renal disease (ESRD). Although Chinese herbal medicine (CHM) use is not uncommon, the feasibility of using CHM among pre-dialysis DN patients remains unclear.Materials and methods: We analyzed a population-based cohort, retrieved from Taiwan’s National Health Insurance Research Database, to study the long-term outcome of using CHM among incident pre-dialysis DN patients from January 1, 2004, to December 31, 2007. All patients were followed up to 5 years or the occurrence of mortality. The risks of all-cause mortality and ESRD were carried out using Kaplan-Meier and competing risk estimation, respectively. Further, we demonstrated the CHM prescriptions and core CHMs using the Chinese herbal medicine network (CMN) analysis.Results: A total of 6,648 incident pre-dialysis DN patients were analyzed, including 877 CHM users and 5,771 CHM nonusers. With overlap weighing for balancing all accessible covariates between CHM users and nonusers, we found the use of CHM was associated with lower all-cause mortality (0.22 versus 0.56; log-rank test: p-value <0.001), and the risk of mortality was 0.42 (95% CI: 0.36–0.49; p-value <0.001) by adjusting all accessible covariates. Further, the use of CHM was associated with a lower risk of ESRD (cause-specific hazard ratio: 0.59, 95%CI: 0.55–0.63; p-value <0.001). Also, from the 5,901 CHM prescriptions, we found Ji-Sheng-Shen-Qi-Wan, Astragalus mongholicus Bunge or (Astragalus membranaceus (Fisch.) Bge.), Plantago asiatica L. (or Plantago depressa Willd.), Salvia miltiorrhiza Bunge, and Rheum palmatum L. (or Rheum tanguticum (Maxim. ex Regel) Balf., Rheum officinale Baill.) were used as core CHMs for different CHM indications. Use of core CHMs was associated with a lower risk of mortality than CHM users without using core CHMs.Conclusions: The use of CHM seemed feasible among pre-dialysis DN patients; however, the beneficial effects still need to be validated by well-designed clinical trials. |
topic |
Chinese herbal medicine diabetic nephropathy end-stage renal disease mortality network analysis pre-dialysis |
url |
https://www.frontiersin.org/articles/10.3389/fphar.2021.616522/full |
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doaj-6a3edf211c194f8bb479cd1adc531d5a2021-04-29T15:24:36ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-02-011210.3389/fphar.2021.616522616522Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort StudyJenny Chun-Ling Guo0Heng-Chih Pan1Heng-Chih Pan2Bo-Yan Yeh3Yen Chu Lu4Jiun-Liang Chen5Jiun-Liang Chen6Ching-Wei Yang7Ching-Wei Yang8Yu-Chun Chen9Yi-Hsuan Lin10Yi-Hsuan Lin11Hsing-Yu Chen12Hsing-Yu Chen13Hsing-Yu Chen14Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, TaiwanDivision of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanSchool of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, TaiwanSchool of Medicine, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDivision of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanGraduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, TaiwanBackground: Chronic kidney disease (CKD) has become a worldwide burden due to the high co-morbidity and mortality. Diabetic nephropathy (DN) is one of the leading causes of CKD, and pre-dialysis is one of the most critical stages before the end-stage renal disease (ESRD). Although Chinese herbal medicine (CHM) use is not uncommon, the feasibility of using CHM among pre-dialysis DN patients remains unclear.Materials and methods: We analyzed a population-based cohort, retrieved from Taiwan’s National Health Insurance Research Database, to study the long-term outcome of using CHM among incident pre-dialysis DN patients from January 1, 2004, to December 31, 2007. All patients were followed up to 5 years or the occurrence of mortality. The risks of all-cause mortality and ESRD were carried out using Kaplan-Meier and competing risk estimation, respectively. Further, we demonstrated the CHM prescriptions and core CHMs using the Chinese herbal medicine network (CMN) analysis.Results: A total of 6,648 incident pre-dialysis DN patients were analyzed, including 877 CHM users and 5,771 CHM nonusers. With overlap weighing for balancing all accessible covariates between CHM users and nonusers, we found the use of CHM was associated with lower all-cause mortality (0.22 versus 0.56; log-rank test: p-value <0.001), and the risk of mortality was 0.42 (95% CI: 0.36–0.49; p-value <0.001) by adjusting all accessible covariates. Further, the use of CHM was associated with a lower risk of ESRD (cause-specific hazard ratio: 0.59, 95%CI: 0.55–0.63; p-value <0.001). Also, from the 5,901 CHM prescriptions, we found Ji-Sheng-Shen-Qi-Wan, Astragalus mongholicus Bunge or (Astragalus membranaceus (Fisch.) Bge.), Plantago asiatica L. (or Plantago depressa Willd.), Salvia miltiorrhiza Bunge, and Rheum palmatum L. (or Rheum tanguticum (Maxim. ex Regel) Balf., Rheum officinale Baill.) were used as core CHMs for different CHM indications. Use of core CHMs was associated with a lower risk of mortality than CHM users without using core CHMs.Conclusions: The use of CHM seemed feasible among pre-dialysis DN patients; however, the beneficial effects still need to be validated by well-designed clinical trials.https://www.frontiersin.org/articles/10.3389/fphar.2021.616522/fullChinese herbal medicinediabetic nephropathyend-stage renal diseasemortalitynetwork analysispre-dialysis |