8/2/2019 suplementos herbales y dao renal

1/3

SN: KidneyPatients UsingHarmful DietarySupplementsBy Charles Bankhead, Staff Writer, MedPage Today

Published: November 12, 2011

Reviewed byRobert Jasmer, MD; Associate Clinical Professor of

Medicine, University of California, San Francisco and

Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

PHILADELPHIA -- From 10% to

15% of patients with chronic

kidney disease reported usingpotentially nephrotoxic dietarysupplements, an analysis of alarge government databaseshowed.

Overall, 52.4% of 21,169 surveyrespondents reported usingdietary supplements. Thelikelihood of self-reported supplement use was increased among individuals

with chronic kidney disease.

Total supplement use included substances identified as potentially nephrotoxicby the National Kidney Foundation in 15.3% of cases.

Action Points

Note that this study was published as an abstract and presented at aconference. These data and conclusions should be considered to bepreliminary until published in a peer-reviewed journal.

Explain that from 10% to 15% of patients with chronic kidney diseasereported using potentially nephrotoxic dietary supplements.

Point out that according to the study, more than half of American adultsuse dietary supplements.

Self-reported use of the potentially harmful supplements declined from 16.1% ofindividuals with no kidney disease to 13.0% of those with stage 1-2 chronic

http://www.medpagetoday.com/reviewer.cfm?reviewerid=55http://www.medpagetoday.com/reviewer.cfm?reviewerid=55http://www.medpagetoday.com/reviewer.cfm?reviewerid=55http://www.medpagetoday.com/MeetingCoverage/ASN/29627?utm_source=cardio-meetings&utm_medium=email&utm_content=acc&utm_campaign=ACCuserid&eun=g21542d2rhttp://www.medpagetoday.com/MeetingCoverage/ASN/29627?utm_source=cardio-meetings&utm_medium=email&utm_content=acc&utm_campaign=ACCuserid&eun=g21542d2rhttp://www.medpagetoday.com/MeetingCoverage/ASN/29627?utm_source=cardio-meetings&utm_medium=email&utm_content=acc&utm_campaign=ACCuserid&eun=g21542d2rhttp://www.medpagetoday.com/reviewer.cfm?reviewerid=55

8/2/2019 suplementos herbales y dao renal

2/3

kidney disease to 10.0% of those with stage 3-4 kidney disease, VanessaGrubbs, MD, reported here at the American Society of Nephrology (ASN)

meeting.

"Although the raw numbers were a little bit lower among people who had kidneydisease, when we accounted for things like age, gender, and education, peoplewho had kidney disease were as likely to be taking a potentially harmful dietarysupplement as those who had no kidney disease at all," Grubbs, of theUniversity of California San Francisco, said during an ASN press briefing.

"This is important because people who have kidney disease, the vast majorityare not aware they have kidney disease. Even among people who haveadvanced kidney disease, less than 10% are aware that they have kidneydisease."

"People are taking these supplements because they think they are improvingtheir health," she added "The fact that the supplements can cause harm that isentirely preventable also is an important point."

The study evolved from the recognition that chronic kidney disease constitutes

a growing problem in the United States, currently affecting an estimated 26million adults, including 500,000 patients on dialysis, said Grubbs. Any stepsthat can be taken to minimize the risk would have major health and economicimplications.

The National Kidney Foundation has identified39 herbal supplementsthat havethe potential to harm the kidneys. Using that list, Grubbs and colleagues

analyzed data from the National Health and Nutrition Examination Survey(NHANES) for the years 1999 to 2008. They identified 21,169 participants whoreported on their supplement use within the past 30 days and whose kidneyfunction was known.

The investigators defined stage 1-2 chronic kidney disease as an albumin-

creatinine ratio 30 g with an estimated glomerular filtration rate (eGFR) 60mL/min/1.73 m2 and stage 3-4 kidney disease as an eGFR of 15 to 59

mL/min/1.73 m

2

.

The proportion of NHANES participants taking supplements was 51.4% amongindividuals without CKD, 49.1% for individuals with stage 1-2 kidney disease,and 65.8% for respondents with stage 3-4 kidney disease (P

8/2/2019 suplementos herbales y dao renal

3/3

"The use of dietary supplements that are potentially harmful in chronic kidneydisease is common and, as use is not statistically different by disease status,

patients with chronic kidney disease may be unaware of the risk," said Grubbs.

"Healthcare providers, too, may be unaware of potentially harmful supplementsand that patients with chronic kidney disease are taking them."

Grubbs had no disclosures. Coauthors disclosed links with Forest Research Institute, Arbor Research

Collaborative, Amgen, the Foundation for Anemia Research, the American Board of Internal Medicine,

Vanderbilt University, and the American Society of Nephrology.

Primary source: American Society of Nephrology

Source reference:

Grubbs V et al. "Prevalent use of dietary supplements potentially harmful in chronic kidney disease in the United

States" ASN2011; Abstract TH-PO267.