Associations Between Using Chinese Herbal Medicine and Long-Term Outcome Among Pre-dialysis Diabetic Nephropathy Patients: A Retrospective Population-Based Cohort Study

• Published in: Frontiers in pharmacology 2021-02, Vol.12, p.616522-616522
• Main Authors: Guo, Jenny Chun-Ling, Pan, Heng-Chih, Yeh, Bo-Yan, Lu, Yen Chu, Chen, Jiun-Liang, Yang, Ching-Wei, Chen, Yu-Chun, Lin, Yi-Hsuan, Chen, Hsing-Yu
• Format: Article
• Language: English
• Subjects: Chinese herbal medicine; diabetic nephropathy; end-stage renal disease; mortality; network analysis; Pharmacology; pre-dialysis
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2021.616522

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. 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. 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: -value