KI failure and cumulative dose of Mutong or Fangji

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Hi All,

 

CUMULATIVE dose of Mutong or Fangji >60g increased the statistical

risk of KI failure in Taiwan:

 

Lai MN, Lai JN, Chen PC, Hsieh SC, Hu FC, Wang JD. Risks of kidney

failure associated with consumption of herbal products containing

Mutong or Fangchi: a population-based case-control study.

Am J Kidney Dis. 2010 Mar;55(3):507-18. Epub 2010 Feb 8.

Institute of Occupational Medicine and Industrial Hygiene, College of

Public Health, National Taiwan University, Taipei, Taiwan.

BACKGROUND: Taiwan has a remarkably high incidence of end-stage renal

disease (ESRD). The objective of this study is to determine the

association between prescribed herbal products containing

aristolochic acid and ESRD. STUDY DESIGN: Population-based case-

control study. SETTING & PARTICIPANTS: All new ESRD cases in Taiwan

and a simple random sample (200,000 people) drawn from the national

health insurance reimbursement database in 1997-2002. PREDICTOR: Age;

sex; hypertension; diabetes; cumulative doses of nonsteroidal anti-

inflammatory drugs, acetaminophen, and adulterated herbal supplements

potentially containing aristolochic acid before the development of

chronic kidney disease; and indications for prescribing such herbs,

including chronic hepatitis, chronic urinary tract infection, chronic

neuralgia, or chronic musculoskeletal diseases. OUTCOMES &

MEASUREMENTS: Occurrence of ESRD through construction of multiple

logistic regression models. RESULTS: There were 36,620 new ESRD cases

from 1998 through 2002. After exclusion of cases with chronic kidney

disease diagnosed before July 1, 1997, there were 25,843 new cases of

ESRD and 184,851 controls in the final analysis. Women, older age,

hypertension, and diabetes were significantly associated with

increased risks of the development of ESRD. After adjustment for

known risk factors, cumulative doses >60 g of Mutong (OR, 1.47 [95%

CI, 1.01-2.14] for 61-100 g; OR, 5.82 [95% CI, 3.89-8.71] for >200 g)

or Fangchi (OR, 1.60 [95% CI, 1.20-2.14] for 61-100 g; OR, 1.94 [95%

CI, 1.29-2.92] for >200 g) were associated with increased risk of the

development of ESRD with a dose-response relationship. This

relationship persisted when analyses were limited to participants who

consumed <500 pills of nonsteroidal anti-inflammatory drugs and those

without diabetes. LIMITATIONS: No measurement of renal function, no

contact with patients, over-the-counter sales were not recorded, and

potential underestimation of exposure dose for cases and ORs.

CONCLUSIONS: Consumption of >60 g of Mutong or Fangchi from herbal

supplements was associated with an increased risk of developing

kidney failure. Copyright 2010 National Kidney Foundation, Inc.

Published by Elsevier Inc. All rights reserved. PMID: 20116155

[PubMed - indexed for MEDLINE]

 

Best regards,