In this study, researchers from Canada, Taiwan, and the U.S. examined end-stage renal disease (ESRD) and mortality rates among patients with diabetic nephropathy (DN) who use traditional Chinese medicine (TCM). The results of their study were published in the journal BMC Complementary and Alternative Medicine.
DN is a common complication of diabetes mellitus and imposes an enormous burden on the health care system.
According to studies, TCM treatments can protect patients from DN, but the long-term impact of TCM use is still unclear.
To address this, the researchers decided to evaluate the rates of ESRD and mortality among TCM users with DN.
They identified 125,490 patients with DN from the National Health Insurance Database in Taiwan and used the landmark method to avoid immortal time bias. They also used propensity score matching to select 1:1 baseline characteristics-matched cohort.
To assess mortality and ESRD rates among the patients, they used the Kaplan-Meier method and competing-risk analysis.
The researchers reported that among the eligible subjects, 60 percent used TCM (65,812 TCM users and 41,482 non-users).
After 1:1 matching, they analyzed the outcomes of 68,882 patients and found that:
For ESRD, the eight-year cumulative incidence for TCM users and non-users were 14.5 percent and 16.6 percent, respectively.
For mortality, the eight-year cumulative incidence for TCM users and non-users were 33.8 percent and 49.2 percent, respectively.
For TCM users, the cause-specific hazard ratio of ESRD and mortality were 0.81 and 0.48, respectively.
The cumulative incidence of mortality rapidly increased among TCM users with ESRD compared with those without.
TCM users who used TCM longer or used TCM after being diagnosed with DN had a lower risk of mortality.
These results were consistent across sensitivity tests with different definitions of TCM users.
Chen HY, Pan HC, Chen YC, Chen YC, Lin YH, Yang SH, Chen JL, Wu HT. TRADITIONAL CHINESE MEDICINE USE IS ASSOCIATED WITH LOWER END-STAGE RENAL DISEASE AND MORTALITY RATES AMONG PATIENTS WITH DIABETIC NEPHROPATHY: A POPULATION-BASED COHORT STUDY. BMC Complementary and Alternative Medicine. 03 April 2019;19(1). DOI: 10.1186/s12906-019-2491-y