4.3 Article

Chinese Herbal Medicine Ameliorated the Development of Chronic Kidney Disease in Patients with Chronic Hepatitis C: A Retrospective Population-Based Cohort Study

Journal

Publisher

HINDAWI LTD
DOI: 10.1155/2019/5319456

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Funding

  1. Health and Welfare Surcharge of Tobacco Products, China Medical University Hospital Cancer Research Center of Excellence [MOHW108-TDU-B-212-124024]
  2. China Medical University Hospital [DMR-108-007, DMR-108-009, DMR-108-044, DMR-107-164, CRS-106-001]
  3. Chinese Medicine Research Center, China Medical University under the Higher Education Sprout Project, Ministry of Education in Taiwan [CMRC-CHM-1]
  4. Ministry of Health and Welfare, Taiwan [MOHW107-TDU-B-212-123004]
  5. China Medical University Hospital
  6. MOST Clinical Trial Consortium for Stroke [MOST 107-2321-B-039 -004-]
  7. Tseng-Lien Lin Foundation, Taichung, Taiwan
  8. Katsuzo and Kiyo Aoshima Memorial Funds, Japan
  9. Academia Sinica Stroke Biosignature Project [BM10701010021]

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Chronic kidney disease (CKD) is a serious complication affecting patients with chronic hepatitis. The effectiveness of CHM for the prevention of CKD in hepatitis patients remains unclear. Therefore, we conducted a retrospective cohort study to investigate the effectiveness of CHM in preventing the development of CKD in hepatitis patients. From a subdataset of the Taiwan National Health Insurance Research Database (NHIRD), we included 19,409 patients newly diagnosed with hepatitis B and hepatitis C between the years 2000 and 2010. After exclusion criteria and 1 : 1 propensity score matching process, we compared demographic factors, comorbidities, and correlated drugs between the CHM and non-CHM cohorts. Statistical analysis was applied to evaluate the differences in characteristic distributions and to compare the cumulative incidence of CKD between the CHM and non-CHM cohorts. This study showed that the patients suffering from hepatitis C with CHM treatment more than 90 days as an adjuvant therapy combined with western medical treatment modalities exhibited a decreased risk of developing CKD (hazard ratio (HR) = 0.40, 95% confidence interval (CI) = 0.21-0.76, p value <0.01). The Kaplan-Meier curve revealed a lower cumulative incidence rate of CKD (p value = 0.004) for the CHM cohort. For further reference, we herein offer the ten most frequently prescribed single herbs and herbal formulas; as such, Salviae miltiorrhizae and Jia-Wei-Xiao-Yao-San were the most commonly prescribed single herb and formula, respectively. This nationwide retrospective cohort study provides evidence that CHM is an effective adjuvant treatment to decrease the risk of developing CKD in hepatitis C patients.

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