| Objective:To investigate the current situation of taking Aristolochic Acid medicines and the prevalence of chronic kidney disease in the general population. Then we analvzed the cornclotion between Aristolochic Acid (AA) and chronic kidney disease(CKD).Methods:A cross-sectional study was conducted. Adults who were older than18years and received healthy physical examination in a tertiary referral hospital in Shandong Provence from September2012to September2013were enrolled in this study. The questionnaire survey included demographic characteristics of the subjects, family history, past history, present history, and conditions of the usage of Aristolochic Acid medicine. All subjects were required to have a medical examination, e.g. height, weight, blood pressure, pulse. We collected specimens including urine samples and venous blood samples for laboratory testing. Urinary albumin and urine creatinine were measured from a fresh morning spot urine sample. Urine samples must be a fresh morning spot urine sample and albumin to urine creatinine ratio (ACR; mg/g creatinine) was calculated. Blood was collected by venipuncture after an overnight fast of at least10hours. According to K/DOQI guide, men with an ACR greater than17mg/g creatinine and women greater than25mg/g were defined as having albuminuria. Decreased kidney function was defined as eGFR<60ml/min/1.73m2. eGFR was calculated with an equation developed by modifying the Modification of Diet in Renal Disease (MDRD) equation based on data from Chinese CKD patients. Chronic intake Aristolochic Acid was defined by at least twice a week, and more than2months. The data were inputted computer using Excel2007. All analyses and calculations were performed by SPSS statistical package, version17.0proportions for categorical variables (e.g. sex and hypertension), and mean±SD(standard deviation) for continuous variables except for ACR, which is presented as median (inter-quartile range, IQR). Continuous variables were presented as mean±SD(standard deviation), and abnormal distribution of measurement data, especially ACR, which is presented as median (inter-quartile range, IQR), and categorical variables were presented as proportions. Comparisons were made using t-test or non-parametric test for continuous variables and chi-square test for categorical variables. Using Multivariable Logistic regression model to explore the factors associated with low eGFR. A P value of less than0.05was considered significant.Results:Altogether8451subjects were invited to participate in the study, and of258participants reported chronic intake of AA, with a prevalence of3.05%. The prevalence of albuminuria, eGFR less than60ml/min/1.73m2, and the overall prevalence of CKD in all subjects were10.1%,3.3%and11.8%. Compared with participators who intake nephrotoxic drugs for a long-term and participators who didn’t intake nephrotoxic drugs, the prevalence of albuminuria, eGFR less than60ml/min/1.73m2, and CKD were12.8%vs.10.0%(P=0.14),10.1%vs.3.1%(P<0.001)%和17.8%vs.11.6%(P=0.004), respectively. Univariate logistic regression analysis showed that age, sex, hypertension, diabetes, lipid metabolic disorder and chronic intake the AA were associated with a decline in kidney function. After adjusting for traditional risk factors, e.g. age, gender, hypertension, diabetes and lipid metabolism disorders, chronic intake nephrotoxic drugs were negatively associated with presence of albuminuria. and positively associated with presence of eGFR less than60ml/min/1.73m2, OR:1.59,95%CI:1.01-2.53,(P=0.045, P<0.05).Conclusions:1. The prevalence of CKD in all subjects was11.8%. The crowd had a higher percentage of high blood pressure with37.7%and lipid metabolism disorders with41.8%. The prevalence of CKD in chronic intake of nephrotoxicity drugs was3.05%. AA is associated with high prevalence of chronic kidney disease (CKD) in adults.2. AA is associated with eGFR less than60ml/min/1.73m2.3. Must be careful with Chinese herbal medicines and preparations containing AA and avoid to cause kidney damage. |
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