Prescribed Renoprotective Chinese Herbal Medicines Were Associated with a Lower Risk of All-Cause and Disease-Specific Mortality among Patients with Chronic Kidney Disease: A Population-Based Follow-Up Study in Taiwan

Chuan-Fa Hsieh; Huan-Cheng Chang; Song-Lih Huang; Chien-Lung Chen; Wei-Ta Chen; Chen-Chang Yang

doi:10.1155/2017/5632195

Prescribed Renoprotective Chinese Herbal Medicines Were Associated with a Lower Risk of All-Cause and Disease-Specific Mortality among Patients with Chronic Kidney Disease: A Population-Based Follow-Up Study in Taiwan

Evid Based Complement Alternat Med. 2017:2017:5632195. doi: 10.1155/2017/5632195. Epub 2017 Jul 17.

Authors

Chuan-Fa Hsieh^{1

2}, Huan-Cheng Chang^{3

4}, Song-Lih Huang⁵, Chien-Lung Chen^{3

6}, Wei-Ta Chen⁷, Chen-Chang Yang^{8

9}

Affiliations

¹ Department of Medical Education and Research, Taiwan Landseed Hospital, No. 77, Guangtai Rd., Pingzhen Dist., Taoyuan 32449, Taiwan.
² Center for General Education, Hsin Sheng College of Medical Care and Management, No. 418, Zhongxing Rd., Longtan Dist., Taoyuan 32555, Taiwan.
³ Division of Nephrology, Department of Medicine, Taiwan Landseed Hospital, No. 77, Guangtai Rd., Pingzhen Dist., Taoyuan 32449, Taiwan.
⁴ Department of Health Care Management, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan 33302, Taiwan.
⁵ Institute of Public Health & Department of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
⁶ Institute of Systems Biology and Bioinformatics, Department of Biomedical Sciences and Engineering, National Central University, No. 300, Zhongda Rd., Zhongli District, Taoyuan 32001, Taiwan.
⁷ Department of Chinese Medicine, Taiwan Landseed Hospital, No. 77, Guangtai Rd., Pingzhen Dist., Taoyuan 32449, Taiwan.
⁸ Institute of Environmental & Occupational Health Sciences, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
⁹ Division of Clinical Toxicology & Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.

Abstract

Chinese herbal medicines (CHMs) containing aristolochic acid (AA) are associated with chronic kidney disease (CKD), but some prescribed CHMs have been shown to possess renoprotective effects. We conducted a nationwide retrospective cohort study to delineate the role of prescribed CHMs on the CKD progression. Renoprotective CHM (RPCHM) was defined if a CHM contained dong chong xia cao (Cordyceps sinensis (Berk.) Sacc.), da huang (Rheum palmatum L), huang qi (Astragalus membranaceus), dan shen (Salvia miltiorrhiza Bge.), and dong quai (Angelica sinensis (Oliv.) Diels) or belonged to specific mixture herbal formulations (Yishen capsule, Saireito, or Wen Pi Tang). Subjects who had ever used AA-containing CHMs, had cancer or HIV prior to CKD diagnosis, or died within the first month of CKD diagnosis were excluded. A total of 11,625 patients were eligible subjects. The adjusted hazard ratio (aHR) for all-cause mortality was 0.6 (p < 0.001) and 0.6 (p = 0.013) among subjects receiving RPCHMs containing Angelica sinensis and those receiving other RPCHMs, respectively. For CKD-related mortality, the aHR among subjects receiving RPCHMs containing Angelica sinensis was 0.6 (p = 0.025). The use of specific RPCHMs, especially those that contained Angelica sinensis, was associated with a lower risk of mortality among CKD patients.