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Department of Internal Medicine Nephrology, Kasr AlAiny School of Medicine, Cairo University, Cairo, Egypt. Electronic address:
Published: November 2015
AI Article Synopsis
Article Abstract
Objective: To explore and compare complementary and alternative medicine (CAM) practice among subsets of patients with chronic kidney disease (CKD) and renal allograft recipients.
Design: Cross-sectional survey questionnaire.
Setting: Three outpatient nephrology clinics and dialysis centers in Egypt.
Subjects: A total of 1005 subjects were included in the study (560 predialyis patients with CKD 3-4, 245 patients on hemodialysis, and 200 transplant recipients).
Intervention: Face to face interview with CKD patients. The survey inquired about epidemiological data, types, sources, and patterns of CAM used as well as the effect of CAM use on the patients' interaction with modern medicine and clinical caregivers.
Main Outcome Measure: (1) Prevalence and types of CAM used by CKD patients; (2) Associations and correlates of CAM use including epidemiological features, impact of CAM use on adherence to conventional treatment and interaction of the users with modern medical systems; (3) Differences in CAM practice between subsets of CKD patients viz. hemodialysis patients, CKD 3-4, and transplant recipients.
Results: Overall, 522 patients (52%) were using CAM (64% of predialyis patients, 33% of dialysis patients, and 40.5% of transplant recipients, P < .001). Herbal and natural products were the most commonly used type of CAM (78%), followed by mind and body procedures (21.6%). CAM users were more likely to be males (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.1-1.6); employed (OR 1.6; 95% CI 1.2-2); urban residents (OR 1.3; 95% CI 1.2-1.5); have higher income (OR 2.6; 95% CI 2-3.6); and higher education (OR 1.6; 95% CI 1.2-2). Seventy nine percent of CAM users did not report their practices to their caregivers mainly because they were not asked; however, transplant recipients were more likely to report P < .02. Compliance to medical treatment was affected in 4.2% of users. Thirty natural products were identified as well as 4 body and mind procedures. The most commonly used herbs were Nigella sativa, Hibiscus sabdariffa, and Cymbopogon proximus. Potentially harmful CAM included intake of licorice and vinegar.
Conclusions: Use of traditional medicine is highly prevalent among CKD patients. Some of these practices are potentially harmful and may affect patient compliance to modern medicine. Physicians commonly ignore to inquire about these practices, which frequently reflect patient frustration with modern medicine efficacy and/or price.
