Prediyaliz Kronik Böbrek Hastalığında bitkisel ilaç kullanımının değerlendirilmesi

Z Amaç Kronik böbrek hastalığı (KBH) nedenlerinden biri nefrotoksik bitkisel ürünler olabilir. Bu çalışma, KBH hastalarında bitkisel ürün kullanım oranı, kullanılan ürünler, tedarik kaynakları, bu ürünlerle akut böbrek yetmezliği gelişip gelişmediği ve bu alanda prediyaliz eğitiminin yerini tespit etmek amacıyla yapıldı. Gereç ve Yöntemler Nefroloji bölümünde 209 hastanın verileri toplandı ve bir prediyaliz eğitim hemşiresi tarafından bire bir hasta görüşmeleriyle doldurulan eğitim formu kullanılarak retrospektif olarak değerlendirildi. Bulgular Hastaların yaş ortalaması 57,3 yıl, % 41'i kadındı. Hastaların % 22’si (n=45) bitkisel ürünler kullanmıştı. Stabil glomerül filtrasyon hızı ile takip edilen yedi hastada bitkisel ürünler kullandıktan sonra akut böbrek hasarı atakları yaşandığı tespit edildi. Hastaların kullandıkları bitkisel ürün isimleri şunlardı: bilinmeyen ot karışımı , siyah kimyon yağı, kiraz sapı, biberiye, tarçın, Helichrysum Arenarium, kaynak suyu, Galyum aparine, reishi mantarı, Ceratonia siliqua, papatya, salyangoz kabuğu, Viburnum opulus, soğan suyu, Sstevia redianadon Bertion, malus trilobata yaprağı, avokado yaprağı, incir ve zeytin yaprağı, at kestanesi, zencefil, cevizi suda bekletip elde edilen su, kabak çekirdeği, Vitex agnus-castus, aloe vera, yaban mersini, ardıç pekmezi, Equisetum arvense L, Lamii albi herba1, yoğurt suyu idi. Altı aydan uzun süre takip edilen hastalar bitkisel ürünleri, diğer hastalardan daha fazla kullanma eğilimindeydiler (p = 0.08). Sonuç Bitkisel ürün kullanımınının yaygınlaşması nedeniyle, klinisyenler hastaların bitkisel ürünlerin kullanımı konusunda daha dikkatli olmalıdırlar. Anahtar kelimeler: Kronik Böbrek Hastalığı, Bitkisel İlaç, Eğitim, İletişim

Evaluation of herbal medicine use in Chronic Kidney Disease

ABSTRACT Background One of the causes of chronic kidney disease (CKD) may be nephrotoxic herbal products. We wanted to ascertain the rate of herbal product use among these CKD patients, the products used, sources of supply, demographic characteristics of the patients, whether acute renal failure develops with these products and the value of predialysis education in this field. Methods The data of 209 patients were collected at the nephrology department and evaluated using a form completed by a CKD education specialist nurse in one-to-one patient interviews. Results The patients’ mean age was 57.3 years, and 41% were female. 22% of the patients (n=45) used herbal products. Seven patients followed up with stable GFR had an acute kidney injury episode after using herbal products. The herbal product names used by the patients were as follows: unknown weed mix, black cumin oil, cherry stalk, rosemary, cinnamon, Helichrysum Arenarium, spring water, Galium aparine, reishi mushroom, Ceratonia siliqua, daisy, snail shell, Viburnum opulus, onion juice, Stevia rebaudiana Bertoni, cranberry, malus trilobata leaf, avocado leaf, fig and olive leaf, horse chestnut, ginger, urtica leaf, eating walnut after soaking it in water, pumpkin seed, Vitex agnus-castus, aloe vera, blueberries, juniper molasses, Equisetum arvense L, Lamii albi herba1, yoghurt water. The patients who were followed for more than six months tended to report their herbal product use more than the remaining patients (p = 0.08). Conclusion Due to the widespread use of herbal products, clinicians should be more careful about the use of herbal products by patients. Key words: Chronic Kidney Disease, Herbal Medicine, Education, Communication

___

  • 1. Jha V. Herbal medicines and chronic kidney disease. Nephrology (Carlton) 2010; 15 Suppl 2:10–17.
  • 2. Isnard Bagnis C, Crepaldi C, Dean J, Goovaerts T, Melander S, Nilsson EL, Prieto-Velasco M, Trujillo C, Zambon R, Mooney A. Quality standards for predialysis education: results from a consensus conference. Nephrol Dial Transplant. 2015;30(7):1058-66. doi: 10.1093/ndt/gfu225. Epub 2014 Jun 23.
  • 3. Ludlow MJ, Lauder LA, Mathew TH, Hawley CM, Fortnum D. Australian consumer perspectives on dialysis: first national census. Nephrology (Carlton). 2012;17(8):703-709.
  • 4. Thorne SE, Robinson CA. Reciprocal trust in health care relationships. J Adv Nurs .1988;13(6):782-9.
  • 5. Eriksson I, Nilsson K. Preconditions needed for establishing a trusting relationship during health counselling - an interview study. J Clin Nurs. 2008;17(17):2352-2359.
  • 6. Louise Shepherd M. Behind the scales:Child and family health nurses taking care of women’s emotional wellbeing. Contemp Nurse. 2011 17;37(2):137-148.
  • 7. Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, Kurella Tamura M, Feldman HI. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713-35. doi: 10.1053/j.ajkd.2014.01.416. Epub 2014 Mar 16.
  • 8. Bardia A, Nisly NL, Zimmerman MB, Gryzlak BM, Wallace RB. Use of herbs among adults based on evidence-based indications: findings from the National Health Interview Survey. Mayo Clin Proc. 2007;82(5):561-566.
  • 9. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998;11;280(18):1569-75. doi: 10.1001/jama.280.18.1569.
  • 10. Myhre MJ. Herbal remedies, nephropathies, and renal disease. Nephrol Nurs J. 2000;27(5):473-478.
  • 11. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med.2005;11(1):42-49.
  • 12. Akyol AD, Yildirim Y, Toker E, Yavuz B. The use of complementary and alternative medicine among chronic renal failure patients. J Clin Nurs. 2011;20(7–8):1035-1043.
  • 13. Gardiner P, Graham RE, Legedza ATR, Eisenberg DM, Phillips RS. Factors associated with dietary supplement use among prescription medication users. Arch Intern Med. 2006; 9:166(18):1968-1974.
  • 14. Goldstein LH, Elias M, Ron-Avraham G, Biniaurishvili BZ, Madjar M, Kamargash I, Braunstein R, Berkovitch M, Golik A. Consumption of herbal remedies and dietary supplements amongst patients hospitalized in medical wards. Br J Clin Pharmacol. 2007;64(3):373-80. doi: 10.1111/j.1365-2125.2007.02878.x. Epub 2007;10.
  • 15. Young LA, Faurot KR, Gaylord SA. Use of and communication about dietary supplements among hospitalized patients. J Gen Intern Med. 2009 19;24(3):366-369.
  • 16. Langley Gc, Klopper H. Trust as a foundation for the therapeutic intervention for patients with borderline personality disorder. J Psychiatr Ment Health Nurs. 2005 ;12(1):23-32.
  • 17. Benkert R, Peters R, Tate N, Dinardo E. Trust of nurse practitioners and physicians among African Americans with hypertension. J Am Acad Nurse Pract. 2008; 20(5):273-280.
  • 18. Belcher M, Jones LK. Graduate nurses experiences of developing trust in the nurse-patient relationship. Contemp Nurse. 2009;31(2):142-152.
  • 19. Trojan L, Yonge O. Developing trusting, caring relationships: home care nurses and elderly clients. J Adv Nurs. 1993;18(12):1903-1910.
  • 20. Benkert R, Pohl JM, Coleman-Burns P. Creating cross-racial primary care relationships in a nurse-managed center. J Cult Divers.2004;11(3):88-99.
  • 21. Bricher G. Paediatric nurses, children and the development of trust. J Clin Nurs. 1999;8(4):451-8.
  • 22. Thompson VL, Hupcey JE, Clark MB. The development of trust in parents of hospitalized children. J Spec Pediatr Nurs.2003;8(4):137-147.
  • 23. Wadell K, Skärsäter I. Nurses’ experiences of caring for patients with a dual diagnosis of depression and alcohol abuse in a general psychiatric setting. Issues Ment Health Nurs. 2007;9:28(10):1125-1140.
  • 24. Gilbert T. Towards a politics of trust. J Adv Nurs. 1998;27(5):1010-1016.
  • 25. Johns JL. A concept analysis of trust. J Adv Nurs. 1996;24(1):76-83.
  • 26. Pask EJ. Trust: an essential component of nursing practice--implications for nurse education. Nurse Educ Today. 1995;15(3):190-195.
  • 27. Hams SP. Concept analysis of trust: a coronary care perspective. Intensive Crit care Nurs. 1997;13(6):351-356.