Complementary and alternative medicine usage among chronic kidney disease patients in a tertiary care setting

Abstract

There is a growing trend of patients with Chronic Kidney Disease (CKD) seeking assistance from Complementary and Alternative Medicine (CAM) in Sri Lanka, influenced by the traditional medical history and cultural beliefs. The lack of tangible evidence of its effectiveness requires a more nuanced understanding of the area, given that there are potentially detrimental effects of certain CAM practices leading to development or worsening of the disease. This study was conducted to investigate the prevalence and patterns of CAM usage among CKD patients and identify potential associated factors among the users. A cross-sectional, observational study was performed at the CKD clinics of Teaching Hospital Peradeniya and National Hospital Kandy from June to August 2023. CKD patients were interviewed using an interviewer-based questionnaire regarding their CAM usage for the treatment of CKD. Out of the total 201 patient responses, 21.9% (n=44) patients admitted to the use of CAM for their CKD condition. Of the patients using CAMs, biologically based therapies were used by 56.8% (n=25), and 50% (n=22) used Ayurvedic medicine, while 40.9% (n=18) claimed to have used mind-body techniques. Out of the CAM users, only 20.5% (n=9) patients asserted to have discussed the use of CAM with their physician. The long duration of the disease showed a statistically significant association with the CAM usage (p=0.03), while gender (p=0.87), ethnicity (p= 0.6), stage of the disease (p=0.5) didn’t show a significant association. This study reveals that a considerable amount of CKD patients uses CAM alongside conventional treatment, whilst only a minority having discussed this with their physician. Also, this study highlights the trend of patients turning towards CAM as the disease progresses. Overall, this study emphasises on the importance of open discussion between patients and healthcare professionals, that may contribute to a more holistic and coordinated approach in managing CKD.