Complementary and alternative medications consumed by renal patients in southern Germany

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).

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

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.

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.

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.