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Association of herbal and dietary supplements with progression and complications of chronic kidney disease: a prospective cohort study

Association of herbal and dietary supplements with progression and complications of chronic kidney disease: a prospective cohort study
Association of herbal and dietary supplements with progression and complications of chronic kidney disease: a prospective cohort study
Aim

To determine associations between herbal and dietary supplement (HDS) use and the progression of chronic kidney disease (CKD), and associations of HDS with uncontrolled hyperphosphataemia in patients with CKD.

Method

The cohort study recruited 406 Thai outpatients with stage 3–5 CKD from two kidney clinics of which 357 were followed up over 12 months. Patients receiving renal replacement therapy prior to recruitment were excluded. Participants were interviewed regarding their HDS use, dietary intake and conventional medication adherence using a questionnaire. The primary outcome was a composite of a decline of at least 5 mL/min per 1.73 m2 per year of estimated glomerular filtration rate and end stage renal disease. Serum creatinine, serum levels of potassium and phosphate were extracted from their medical notes over the 12 months. χ2 tests and multiple logistic regression analyses were performed to ascertain any associations.

Results

Despite no association between HDS and the progression of CKD over a one‐year period (adjusted odds ratio (OR) 1.16, 95% confidence interval (CI) 0.66–2.03), two patients had acute kidney injury, which may be related to an unknown Chinese herbal medicine, or river spiderwort combined with diclofenac reported in the medical notes. The use of HDS was associated with uncontrolled hyperphosphataemia (adjusted OR 3.53, 95%CI 1.20–10.43).

Conclusions

The findings suggest that HDS are likely to be related to acute kidney injury rather than the progression of CKD in Thai patients with CKD. The products were associated with uncontrolled hyperphosphataemia. Patients who have CKD and use HDS should be closely monitored regarding their kidney function and electrolytes.
1320-5358
679-687
Tangkiatkumjai, Mayuree
152047e2-cbfd-4d6e-9864-6576f11a646a
Boardman, Helen
22a0361b-3e8a-4189-a9b9-8406f0d5b4af
Praditpornsilpa, Kearkiat
37674b23-cbc2-488b-a760-5a84d7c9be31
Walker, Dawn-Marie
5d4c78b7-4411-493e-8844-b64efc72a1e8
Tangkiatkumjai, Mayuree
152047e2-cbfd-4d6e-9864-6576f11a646a
Boardman, Helen
22a0361b-3e8a-4189-a9b9-8406f0d5b4af
Praditpornsilpa, Kearkiat
37674b23-cbc2-488b-a760-5a84d7c9be31
Walker, Dawn-Marie
5d4c78b7-4411-493e-8844-b64efc72a1e8

Tangkiatkumjai, Mayuree, Boardman, Helen, Praditpornsilpa, Kearkiat and Walker, Dawn-Marie (2015) Association of herbal and dietary supplements with progression and complications of chronic kidney disease: a prospective cohort study. Nephrology, 20 (10), 679-687. (doi:10.1111/nep.2015.20.issue-10).

Record type: Article

Abstract

Aim

To determine associations between herbal and dietary supplement (HDS) use and the progression of chronic kidney disease (CKD), and associations of HDS with uncontrolled hyperphosphataemia in patients with CKD.

Method

The cohort study recruited 406 Thai outpatients with stage 3–5 CKD from two kidney clinics of which 357 were followed up over 12 months. Patients receiving renal replacement therapy prior to recruitment were excluded. Participants were interviewed regarding their HDS use, dietary intake and conventional medication adherence using a questionnaire. The primary outcome was a composite of a decline of at least 5 mL/min per 1.73 m2 per year of estimated glomerular filtration rate and end stage renal disease. Serum creatinine, serum levels of potassium and phosphate were extracted from their medical notes over the 12 months. χ2 tests and multiple logistic regression analyses were performed to ascertain any associations.

Results

Despite no association between HDS and the progression of CKD over a one‐year period (adjusted odds ratio (OR) 1.16, 95% confidence interval (CI) 0.66–2.03), two patients had acute kidney injury, which may be related to an unknown Chinese herbal medicine, or river spiderwort combined with diclofenac reported in the medical notes. The use of HDS was associated with uncontrolled hyperphosphataemia (adjusted OR 3.53, 95%CI 1.20–10.43).

Conclusions

The findings suggest that HDS are likely to be related to acute kidney injury rather than the progression of CKD in Thai patients with CKD. The products were associated with uncontrolled hyperphosphataemia. Patients who have CKD and use HDS should be closely monitored regarding their kidney function and electrolytes.

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More information

Accepted/In Press date: 31 May 2015
e-pub ahead of print date: 4 June 2015
Published date: October 2015

Identifiers

Local EPrints ID: 430000
URI: http://eprints.soton.ac.uk/id/eprint/430000
ISSN: 1320-5358
PURE UUID: 1cffd9d0-a41d-42d2-bf38-0cc3012cb98f
ORCID for Dawn-Marie Walker: ORCID iD orcid.org/0000-0003-2135-1363

Catalogue record

Date deposited: 09 Apr 2019 16:30
Last modified: 16 Mar 2024 04:20

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Contributors

Author: Mayuree Tangkiatkumjai
Author: Helen Boardman
Author: Kearkiat Praditpornsilpa
Author: Dawn-Marie Walker ORCID iD

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