| Title | Effectiveness of Chinese herbal medicine combined with Western medicine on deferring dialysis initiation for nondialysis chronic kidney disease stage 5 patients: a multicenter prospective nonrandomized controlled study |
| Authors | Wu, Yifan Li, Chuang Zhang, Lei Zou, Chuan Xu, Peng Wen, Zehuai Ouyang, Wenwei Yang, Nizhi Zhang, Min Lin, Qizhan Lu, Fuhua Wang, Lixin Bao, Kun Zhao, Daixin Fu, Lizhe Guo, Xinfeng Yang, Lihong Ou, Aihua He, Zehui Weng, Heng Li, Jianmin Shi, Wei Wang, Xiaoqin Song, Liqun Zhan, Yongli Sun, Wei Wei, Lianbo Wang, Niansong Gui, Dingkun Zhan, Jihong Lu, Ying Chen, Hongyu Liu, Yuning Yang, Hongtao Chen, Ming Wang, Yiping Zhang, Peiqing Deng, Yueyi Meng, Lanfen Cheng, Xiaohong Li, Feng Yu, Dajun Xu, Damin Fang, Jing'ai Li, Hongyan Fu, Junzhou Xie, Yuansheng Li, Wenge Zhao, Jinghong Huang, Yuanhang Lu, Zhaoyu Su, Guobin Zhang, La Qin, Xindong Xu, Yuan Peng, Yu Hou, Haijing Deng, Lili Liu, Hui Jie, Xina Liu, Lichang Tang, Fang Pei, Hongfei Li, Ping Mao, Wei Liu, Xusheng |
| Affiliation | Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Dept Nephrol, Affiliated Hosp 2, 111,Dade Rd, Guangzhou 510120, Peoples R China Guangzhou Univ Chinese Med, State Key Lab Dampness Syndrome Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, 111,Dade Rd, Guangzhou 510120, Peoples R China Guangzhou Univ Chinese Med, Key Unit Methodol Clin Res, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou, Peoples R China Guangzhou Univ Chinese Med, Affiliated Hosp 2, Guangzhou, Peoples R China Guangzhou Univ Chinese Med, Evidence Based Med & Clin Res Serv Grp, Guangdong Prov Acad Chinese Med Sci, Guangdong Prov Hosp Chinese Med,Affiliated Hosp 2, Guangzhou, Peoples R China Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Dept Big Med Data, Dept Clin Epidemiol,Affiliated Hosp 2, Guangzhou, Peoples R China Guangzhou Univ Chinese Med, Dept Spleen & Stomach Dis, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou, Peoples R China Guangxi Univ Chinese Med, Dept Nephrol, Affiliated Hosp 1, Nanning, Peoples R China Hubei Prov Hosp Chinese Med, Dept Nephrol, Wuhan, Peoples R China Heilongjiang Univ Chinese Med, Affiliated Hosp 1, Dept Nephrol, Harbin, Peoples R China China Acad Tradit Chinese Med, Guanganmen Hosp, Dept Nephrol, Beijing, Peoples R China Jiangsu Prov Hosp Chinese Med, Dept Nephrol, Nanjing, Peoples R China Southern Med Univ, Dept Nephrol, TCM Integrated Hosp, Guangzhou, Peoples R China Shanghai Jiao Tong Univ, Dept Nephrol, Peoples Hosp 6, Shanghai, Peoples R China Guiyang Coll Tradit Chinese Med, Dept Nephrol, Affiliated Hosp 1, Guiyang, Peoples R China Tong Hosp, Dept Nephrol, Hangzhou, Zhejiang, Peoples R China Hangzhou Hosp Chinese Med, Dept Nephrol, Hangzhou, Peoples R China Beijing Univ Chinese Med, Dongzhimen Hosp, Dept Nephrol, Beijing, Peoples R China Tianjin Univ Chinese Med, Affiliated Hosp 1, Dept Nephrol, Tianjin, Peoples R China Chengdu Univ Tradit Chinese Med, Dept Nephrol, Affiliated Hosp, Chengdu, Peoples R China Anhui Prov Hosp Chinese Med, Dept Nephrol, Hefei, Peoples R China Heilongjiang Acad Tradit Chinese Med, Dept Nephrol, Harbin, Peoples R China Shanghai Univ Tradit Chinese Med, Longhua Hosp, Dept Nephrol, Shanghai, Peoples R China Liuzhou Hosp Tradit Chinese Med, Dept Nephrol, Liuzhou, Peoples R China Shaanxi Prov Hosp Chinese Med, Dept Nephrol, Xian, Peoples R China Fourth Mil Med Univ, Dept Nephrol, Xijing Hosp, Xian, Peoples R China Acad Tradit Chinese Med, Xiyuan Hosp, Dept Nephrol, Beijing, Peoples R China Peking Univ First Hosp, Dept Nephrol, Beijing, Peoples R China Shanxi Med Univ, Hosp 1, Dept Nephrol, Taiyuan, Peoples R China Huadu Dist Peoples Hosp Guangzhou, Dept Nephrol, Guangzhou, Peoples R China Guangzhou 1 Peoples Hosp, Dept Nephrol, Guangzhou, Peoples R China China PLA Gen Hosp, Dept Nephrol, Beijing, Peoples R China China Japan Friendship Hosp, Dept Nephrol, Beijing 100029, Peoples R China Third Mil Med Univ, Dept Nephrol, Xinqiao Hosp, Chongqing, Peoples R China Gen Hosp Guangzhou Mil Command PLA, Dept Nephrol, Guangzhou, Peoples R China Guangzhou Univ Chinese Med, Guangdong Prov Key Lab Clin Res Tradit Chinese Me, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, 111,Dade Rd, Guangzhou 510120, Peoples R China |
| Keywords | ARTERIAL BLOOD-PRESSURE CHRONIC-RENAL-FAILURE BODY-MASS INDEX DIABETIC-NEPHROPATHY ERYTHROPOIETIN THERAPY SERUM BICARBONATE PORIA-COCOS PROGRESSION MORTALITY INFLAMMATION |
| Issue Date | Mar-2021 |
| Publisher | ANNALS OF TRANSLATIONAL MEDICINE |
| Abstract | Background: In clinical practice, Chinese herbal medicine (CHM) purportedly has beneficial therapeutic effects for chronic kidney disease (CKD), which include delaying disease progression and dialysis initiation. However, there is a lack of high-quality evidence-based results to support this. Therefore, this study aimed to evaluate the efficacy of CHM combined with Western medicine in the treatment of stage 5 CKD. Methods: This was a prospective nonrandomized controlled study. Stage 5 CKD (nondialysis) patients were recruited form 29 AAA class hospitals across China from July 2014 to April 2019. According to doctors? advice and the patients? wishes, patients were assigned to the CHM group (Western medicine + CHM) and the non-CHM group (Western medicine). Patient demographic data, primary disease, blood pressure, Chinese and Western medical drugs, clinical test results, and time of dialysis initiation were collected during follow-up. Results: A total of 908 patients were recruited in this study, and 814 patients were finally included for further analysis, including 747 patients in the CHM group and 67 patients in the non-CHM group. 482 patients in the CHM group and 52 patients in the non-CHM group initiated dialysis. The median time of initiating dialysis was 9 (7.90, 10.10) and 3 (0.98,5.02) months in the CHM group and non-CHM group, respectively. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis [adjusted hazard ratio (aHR): 0.38; 95% confidence interval (CI): 0.28, 0.53] compared to those in the non-CHM group. After 1:2 matching, the outcomes of 160 patients were analyzed. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis (aHR: 0.32; 95% CI: 0.21, 0.48) compared to patients in the non-CHM group. Also, the Kaplan-Meier analysis demonstrated that the cumulative incidence of dialysis in the CHM group was significantly lower than that in the non-CHM group (log-rank test, P<0.001) before and after matching. Conclusions: This study suggest that the combination of CHM and Western medicine could effectively reduce the incidence of dialysis and delay the time of dialysis initiation in stage 5 CKD patients. Background: In clinical practice, Chinese herbal medicine (CHM) purportedly has beneficial therapeutic effects for chronic kidney disease (CKD), which include delaying disease progression and dialysis initiation. However, there is a lack of high-quality evidence-based results to support this. Therefore, this study aimed to evaluate the efficacy of CHM combined with Western medicine in the treatment of stage 5 CKD. Methods: This was a prospective nonrandomized controlled study. Stage 5 CKD (nondialysis) patients were recruited form 29 AAA class hospitals across China from July 2014 to April 2019. According to doctors' advice and the patients' wishes, patients were assigned to the CHM group (Western medicine + CHM) and the non-CHM group (Western medicine). Patient demographic data, primary disease, blood pressure, Chinese and Western medical drugs, clinical test results, and time of dialysis initiation were collected during follow-up. Results: A total of 908 patients were recruited in this study, and 814 patients were finally included for further analysis, including 747 patients in the CHM group and 67 patients in the non-CHM group. 482 patients in the CHM group and 52 patients in the non-CHM group initiated dialysis. The median time of initiating dialysis was 9 (7.90, 10.10) and 3 (0.98,5.02) months in the CHM group and non-CHM group, respectively. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis [adjusted hazard ratio (aHR): 0.38; 95% confidence interval (CI): 0.28, 0.53] compared to those in the non-CHM group. After 1:2 matching, the outcomes of 160 patients were analyzed. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis (aHR: 0.32; 95% CI: 0.21, 0.48) compared to patients in the non-CHM group. Also, the Kaplan-Meier analysis demonstrated that the cumulative incidence of dialysis in the CHM group was significantly lower than that in the non-CHM group (log-rank test, P<0.001) before and after matching. Conclusions: This study suggest that the combination of CHM and Western medicine could effectively reduce the incidence of dialysis and delay the time of dialysis initiation in stage 5 CKD patients. |
| URI | http://hdl.handle.net/20.500.11897/622355 |
| ISSN | 2305-5839 |
| DOI | 10.21037/atm-21-871 |
| Indexed | SCI(E) |
| Appears in Collections: | 第一医院 |
