Original Research
Complementary and Alternative Medications Consumed by Renal Patients in Southern Germany

https://doi.org/10.1053/j.jrn.2008.08.008Get rights and content

Background

Complementary and alternative medicine (CAM) is frequently used in the general population, yet scant data are available regarding the prevalence of these medications in patients with end-stage renal disease (ESRD).

Objective

To survey patients with ESRD regarding their use of CAM and health foods.

Methods

Consecutive patients treated with dialysis or renal transplantation for ESRD were approached by nephrologists of 5 renal centers to report their usage of and knowledge on CAM and health foods by answering a questionnaire. Of 180 approached patients, 164 returned completed questionnaires for analysis.

Results

Fifty-seven percent of dialysis patients and 49% of transplant patients reported to be regular CAM-consumers. CAM consumption was positively associated with female sex and negatively with diabetes as comorbidity. Forty-one different CAM products had been named, with mineral supplements and vitamins ranking first. Besides CAM, many renal patients had regularly consumed herbal teas and citrus-juices (50% and 35%, respectively). Close to 40% of the documented CAM/health food consumptions have potential risks for patients because of constituents that either accumulate in renal failure or interact with pharmaceutical medication. However, only about 50% of dialysis patients, but 73% of transplant patients used to inform their physicians about CAM consumption (P = .005). Awareness about interaction risks linked to CAM was especially low in dialysis patients when compared to transplant patients (39% versus 78%, P < .0001) and increased when physicians had routinely questioned patients about their CAM consumption. Currently, however, patients reported that only a minority of physicians had taken an active interest into consumption of these substances.

Conclusion

Consumption of CAM and health food is common among renal patients. Physicians are currently not adequately informed about CAM consumption by their patients. Because many products are at risk to either accumulate or cause interactions with medication, physicians should take an active role to inform themselves.

Section snippets

Methods

This was a cross-sectional, descriptive study of renal patients, using a questionnaire on CAM consumption including vitamin and mineral supplements, fruit juices, herbs, herbal teas, and other commonly used nutritional supplements. Informed consent was obtained from patients after they had received a letter inviting them to participate and informing them about the intention of the study. Consecutive dialysis patients and transplant recipients of 5 outpatient renal departments with associated

Demography of Patients

Of 180 questionnaires handed out to patients, 164 completed questionnaires (91%) were returned and could be analyzed. Questionnaires from 45 (30 male/15 female) current transplant patients and 119 (60 male/59 female) dialysis patients were analyzed. The overall mean age of patients was 60 ± 10 years (range, 19 to 88 years), and 24% were diabetic, with a higher proportion of diabetic patients on dialysis than with transplants (28% vs. 13%, respectively). Gender was unevenly distributed in some

Discussion

This cross-sectional study documents the consumption of CAMs among dialysis patients and transplant recipients of 5 renal centers in southern Germany. Consecutive dialysis and transplant patients, under the care of nephrologists, were eligible to participate if they could answer a questionnaire without assistance. This investigation had been motivated by repeatedly observed complications linked to CAMs in renal patients,10, 11, 12, 13, 14 and by the fact that patients seek alternative advice on

Conclusion

The documented consumption of CAMs and health foods in renal patients is relevant in the planning and supervision of medical treatments. A considerable number of products are unsuitable for renal patients because their constituents either accumulate or cause interactions with pharmaceutical medications. Besides CAMs, herbal teas and fruit juices are widely consumed by patients, and should be considered potential sources of interactions. It is worrisome that physicians are evidently not

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