Non-aristolochic acid prescribed Chinese herbal medicines and the risk of mortality in patients with chronic kidney disease: results from a population-based follow-up study.
Non-aristolochic acid prescribed Chinese herbal medicines and the risk of mortality in patients with chronic kidney disease: results from a population-based follow-up study.
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非阿里斯洛胆道酸开了中草药和慢性肾脏疾病患者死亡率的风险：基于人群的随访研究的结果。
DOI：
10.1136/bmjopen-2013-004033
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发表时间：
2014-02-21
期刊：
影响因子：
2.9
通讯作者：
Yang CC
中科院分区：
文献类型：
--
作者：
Hsieh CF;Huang SL;Chen CL;Chen WT;Chang HC;Yang CC
目的：探讨慢性肾脏病(CKD)患者非马兜铃酸(AA)类中草药的使用与死亡风险的关系。全国范围内以人群为基础的随访研究。纵向健康保险资料库，取自台湾国民健康保险研究资料库。共有47876名慢性肾脏病患者被确认为 。曾使用过含AA的中药、在CKD诊断前患有癌症或HIV、在CKD诊断的第一个月内死亡以及不是台湾公民的参与者被排除在外。共有13名 864名参与者有资格进入最终分析。2000至2008年间慢性肾脏病患者的全因死亡率。在控制了潜在的混杂因素后，我们发现，在诊断CKD后开始接受非AA处方中药治疗的参与者与不使用非AA处方中药的参与者相比，死亡风险较低(调整后的HR(AHR)为0.6；95%CI为0.4至0.7，p<；0.001)。此外，在诊断CKD之前和之后使用非AA处方中药的参与者也比不使用的参与者死亡率低(AHR0.6；95%可信区间0.5至0.8，p<；0.001)。在亚组分析中，我们发现这种反向关联只存在于没有资格接受促红细胞生成素治疗的患者中(即血清肌酐≦6 mg/dL和/或红细胞压积≧28%)。在CKD确诊后接受非再障中药治疗的患者，在促红细胞生成素治疗开始之前，其死亡率比没有接受治疗的患者低。
To evaluate the relationship between the use of non-aristolochic acid (AA) prescribed Chinese herbal medicines (CHMs) and the risk of mortality in patients with chronic kidney disease (CKD). Nationwide population-based follow-up study. Longitudinal health insurance database sampled from the Taiwan National Health Insurance Research Database. A total of 47 876 patients with CKD were identified. Participants who had ever used AA-containing CHMs, had cancer or HIV prior to the diagnosis of CKD, died within the first month of CKD diagnosis and who were not Taiwanese citizens were excluded. A total of 13 864 participants were eligible for final analysis. All-cause mortality among patients with CKD between 2000 and 2008. After controlling for potential confounders, we found that participants who started to receive non-AA prescribed CHMs after the diagnosis of CKD had a lower risk of mortality as compared with non-users of non-AA prescribed CHMs (adjusted HR (aHR) 0.6; 95% CI 0.4 to 0.7, p<0.001). Moreover, participants who had used non-AA prescribed CHMs prior to and after the diagnosis of CKD also had a lower risk of mortality than non-users (aHR 0.6; 95% CI 0.5 to 0.8, p<0.001). In subgroup analyses, we found that such an inverse association was present only among patients who were not eligible to receive erythropoietin therapy (ie, serum creatinine ≦6 mg/dL and/or haematocrit value ≧28%). Patients who received non-AA prescribed CHMs after the diagnosis of CKD, yet before the start of erythropoietin therapy had a lower risk of mortality than those who did not.
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