The use of complementary and alternative medicine among dialysis patients

Context • The use of complementary and alternative medicine (CAM) has been on the rise in the last decade. Subpopulations of patients with chronic diseases are at risk for adverse events and potential drug-herb interactions, among them dialysis patients. Objective • The study aimed to evaluate the prevalence of CAM consumption among dialysis patients and to search for potential interactions. Design • The study was cross-sectional, based on questionnaires. Setting • The study occurred in the hemodialysis unit at Assaf Harofeh Medical Center (Zeriffin, Israel). Participants • Participants were patients of the hemodialysis unit. Outcome Measures • The questionnaires obtained demographic data, information about a patient’s medical history and use of prescription medication, and all relevant history of CAM use, including the interest of the medical team in the patient’s use of supplements. Results • Eighty-four patients participated in the study. Eight patients (9.5%) had used CAM, 5 of whom were women (62.5%). Of the CAM consumers, 4 (50%) had more than 12 y of education vs 14 (8.4%) in the nonconsumer group (P = .061). Six of the consumers were professionals (75%) in comparison with 30 (39.5%) of the nonconsumers, although that difference was not statistically significant (P = .22). The CAM users’ monthly incomes were significantly better than that of the nonconsumers (P = .01). No differences were found regarding smoking, alcohol consumption, or physical activity. The study found potential drug-herb interactions in 4 (50%) of the CAM consumers. Moderate potential interactions were found between Aloe vera and diuretics; Aloe vera and insulin; pyridoxine and calcium-channel blockers and diuretics; and niacin and statins. Those interactions had the potential to result in hypoglycemia, hyperglycemia, hypokalemia, and lower blood pressure. Conclusions • The study found a lower prevalence of CAM consumption in dialysis patients than had been found in other studies of the general population. Still, the unawareness of the harm and potential interactions and the lack of data sharing between the patients and caregivers might have had disastrous consequences. Therefore, caregivers need to inquire of their patients specifically about their use of CAM, especially for populations with chronic diseases, let alone patients undergoing dialysis.