The evidence on whether Chinese herbal medicines affect outcome in patients with chronic kidney disease (CKD) is limited. Here we retrospectively explored the association of prescribed Chinese herbal medicine use and the risk of end-stage renal disease (ESRD) in patients with CKD. Patients with newly diagnosed CKD in the Taiwan National Health Insurance Research Database from 2000 to 2005 were categorized into new use or nonuse of prescribed Chinese herbal medicine groups. These patients were followed until death, dialysis initiation, or till the end of 2008. Among the 24,971 study patients, 11,351 were new users of prescribed Chinese herbal medicine after CKD diagnosis. Overall, after adjustment for confounding variables, the use group exhibited a significant 60% reduced ESRD risk (cause-specific hazard ratio 0.41, 95% confidence interval 0.37-0.46) compared with the nonuse group. The change was significantly large among patients using wind dampness-dispelling formulas (0.63, 0.51-0.77) or harmonizing formulas (0.59, 0.46-0.74), suggesting an independent association between specific Chinese herbal medicines and reduced ESRD risk. The findings were confirmed using propensity score matching, stratified analyses, and three weighting methods. However, dampness-dispelling and purgative formulas were associated with increased ESRD risk. Thus, specific Chinese herbal medicines are associated with reduced or enhanced ESRD risk in patients with CKD.

Key Points Question What is the association of hearing loss with future incident dementia in the general population of Taiwan? Findings In this population-based matched cohort study of 16 270 participants, hearing loss was positively associated with incident dementia, especially in patients aged 45 to 64 years. Meaning Hearing loss is associated with a higher risk of dementia, and findings suggest that hearing protection, screening, and treatment may be used as strategies to mitigate this potential risk factor.

Key Points Question Is attention-deficit/hyperactivity disorder (ADHD) associated with higher early mortality risk among patients in Taiwan? Findings In this Taiwan nationwide population-based cohort study, there were 275 980 patients with ADHD and 1 931 860 matched controls. After adjustment for potential confounders, patients with ADHD had significantly elevated early mortality risk for suicide, homicide, and unintentional injuries compared with the non-ADHD group. Meaning These findings suggest that ADHD may be associated with excess mortality from injury causes.