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

Abstract

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.

Integration of Chinese Herbal Medicine into Routine Care Was Related to Lower Risk of Chronic Kidney Disease in Patients with Rheumatoid Arthritis: A Population-Based Nested Case–Control Study in Taiwan

“…This result was similar to that of from another retrospective population-based cohort study among hepatitis patients. 19 Its components are believed to reduce the blood pressure and exert anti-oxidative, anti-fibrotic, and anti-thrombotic effects. Tetrahydropalmatine, one of the active components isolated from Yan-Hu-Suo, was found to possess antihypertensive activity by decreasing hypothalamic serotonin and noradrenaline release in the rodent model.…”

TGF-β/Smad Signaling Pathway in Tubulointerstitial Fibrosis

“…Recently, a randomized controlled trial showed Bupi yishen formula mitigated patients with non-diabetic stage 4 CKD ( Mao et al, 2020 ). Moreover, a retrospective population-based cohort study showed that Chinese herbal medicine, such as Salviae miltiorrhizae and Jia-Wei-Xiao-Yao-San, mitigated CKD in patients with chronic hepatitis C ( Chang et al, 2019 ). So far, although TCMs have been used for treating patients with CKD, few study demonstrated that TCMs were applied to treatment kidney diseases through targeting TGF-β/Smad signaling pathway.…”