Effect of geography, age, and using Chinese herb on incidence and prevalence of chronic kidney disease/end-stage renal disease in Taiwan

• Main Authors: Ming-Yen Lin, 林明彥
• Other Authors: Ming-Tsang Wu
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/69834443654150984265

博士 === 高雄醫學大學 === 職業安全衛生研究所 === 101 === Background: The incident and prevalent rate of end-stage renal disease (ESRD) in Taiwan is the high rank in the world. Fewer study explored the variation of geography, age and using Chinese herbal medicine on incident of ESRD. In the study, we would like to explore the role of geography, age, and using of Chinese herb on incidence of ESRD and prevalence of chronic kidney disease (CKD) in Taiwan. Methods: This study includes three sections. The first part, we used data of Taiwan Renal Data Registry System from 2000 through 2007, and population data from the Central Institute of Statistics from 1999 through 2008 to conduct an ecological study. Secondly, we explore the age effect on factors associated with CKD through a community-based survey in Kaohsiung County. Finally, we used National Health Insurance dataset to inspect weather using of prescribed Chinese herb after diagnosis of CKD increase risk for ESRD. Directed standardization, geospatial statistics, mixed model, survey logistic regression, and competing risk and time dependent Cox regression was used for these studies if appropriate. We considered statistical significant while p-value less than 0.05. Results: Incidence of ESRD from 2000 through 2007 is higher in southern region (coefficient [95%CIs] , 73.05 [26.11, 120.00]) and eastern region (73.73 [10.23, 137.23]) compared to north region within Taiwan, and higher percentage of elderly rate (21.97 [8.76, 35.18]) had higher incidence of ESRD. Gout, hepatitis B virus infection, and using Long Dan Xie Gan Tang was significantly positive associated with CKD only in persons aged <60 (odds ratios [95% CIs], 3.15 [1.96–5.07], 1.66 [1.09–2.53], 8.86 [1.73–45.45], respectively). However, diabetes, stroke, chronic kidney disease, and non-using analgesic injection were significantly associated with CKD only in persons aged equal and higher 60(odds ratios [95% CIs], 3.58 [2.06–6.22], 3.66 [1.58–8.43], 3.89 [1.09–13.87], 2.27 [1.21–4.17], respectively). Prescribed Chinese herb use after diagnosis of CKD may decrease risk for ESRD (hazard ratio [95%CIs], 0.18 [0.06-0.55] ). Conclusion: This study found regional variation on incidence of ESRD is existence; different risk factors contribute to prevalence of CKD, and using prescribed Chinese herb may decrease risk to ESRD in patient with CKD. This information provides additional evidence for government to carry out strategies to reduce incidence of ESRD in Taiwan.