Chin Jia Wen, Abdullah Rafidah, Tan Benjamin Wei Wang, Wong Koh Wei, Khor Ban-Hock
Nutrition Program, Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Malaysia.
Department of Medicine, Hospital Putrajaya 62250 Putrajaya, Malaysia.
J Integr Med. 2025 Jul;23(4):370-381. doi: 10.1016/j.joim.2025.05.001. Epub 2025 May 10.
The use of complementary and alternative medicine (CAM) is common among individuals with underlying chronic illnesses.
This systematic review and meta-analysis investigated the global prevalence and patterns of CAM use among individuals with chronic kidney disease (CKD).
PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature Plus were searched from inception until 26th February 2024.
Original articles reporting the use of at least one type of CAM among individuals aged above 18 years old and at all stages of CKD or undergoing any form of kidney replacement therapy.
Two independent reviewers performed the literature screening. The data were extracted from the included studies by one reviewer and cross-checked by another. Discrepancies were resolved by discussion and consensus among two reviewers. Primary information included prevalence of CAM use, types of CAM used, reasons for CAM use, factors associated with CAM use, and disclosure to healthcare providers. Meta-analyses were performed to determine the pooled prevalence of CAM use and non-disclosure of CAM using a random effect model.
Forty-one studies were included in this systematic review and meta-analysis. The pooled prevalence of CAM use was 43% (95% confidence interval: 34%, 51%), I = 99.46%. The reasons for CAM use included treatment of underlying comorbidities, complications or symptoms, maintenance of general health, and treatment of CKD. Nutritional approaches were the most common CAM modality, with 412 different herbal and dietary supplements reported; psychological and physical approaches included massage therapy, relaxation techniques, and mind-body practices; and other complementary health approaches such as homeopathy, traditional Chinese medicine, and Ayurvedic medicine were also frequently reported. Factors associated with CAM use included sociodemographic characteristics such as older age, female gender, or higher income; disease or therapy factors such as not having diabetes, relying on hemodialysis, or poor adherence to medication; and patient or internal factors such as positive attitude towards CAM and perceived safety of CAM. About 66% (61%, 72%) of CAM users did not disclose the use of CAM to their healthcare providers.
CAM use is prevalent among individuals with CKD, and healthcare providers should communicate openly and effectively to emphasize the rational use of CAM to avoid potential harm. Please cite this article as: Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. Prevalence and patterns of complementary and alternative medicine usage among adults with chronic kidney disease: A systematic review and meta-analysis. J Integr Med. 2025; 23(4): 370-381.
补充和替代医学（CAM）在患有慢性基础疾病的个体中使用较为普遍。
本系统评价和荟萃分析调查了慢性肾脏病（CKD）患者中CAM使用的全球患病率及模式。
检索了PubMed、Embase以及护理与联合健康文献累积索引Plus，检索时间从建库至2024年2月26日。
原始文章报告了18岁以上各个CKD阶段或正在接受任何形式肾脏替代治疗的个体中至少使用一种CAM的情况。
两名独立审阅者进行文献筛选。由一名审阅者从纳入研究中提取数据，另一名审阅者进行交叉核对。通过两名审阅者的讨论和协商解决分歧。主要信息包括CAM使用的患病率、使用的CAM类型、使用CAM的原因、与CAM使用相关的因素以及向医疗服务提供者的披露情况。采用随机效应模型进行荟萃分析，以确定CAM使用和未披露CAM使用情况的合并患病率。
本系统评价和荟萃分析纳入了41项研究。CAM使用的合并患病率为43%（95%置信区间：34%，51%），I² = 99.46%。使用CAM的原因包括治疗基础合并症、并发症或症状、维持总体健康以及治疗CKD。营养方法是最常见的CAM方式，报告了412种不同的草药和膳食补充剂；心理和身体方法包括按摩疗法、放松技巧和身心练习；其他补充健康方法如顺势疗法、传统中医和阿育吠陀医学也经常被报告。与CAM使用相关的因素包括社会人口学特征，如年龄较大、女性或收入较高；疾病或治疗因素，如没有糖尿病、依赖血液透析或药物依从性差；以及患者或内在因素，如对CAM的积极态度和对CAM的感知安全性。约66%（61%，72%）的CAM使用者未向其医疗服务提供者披露使用CAM的情况。
CKD患者中CAM的使用较为普遍，医疗服务提供者应进行开放和有效的沟通，强调合理使用CAM以避免潜在危害。请引用本文：Chin JW, Abdullah R, Tan BWW, Wong KW, Khor BH. 慢性肾脏病成人补充和替代医学使用的患病率及模式：一项系统评价和荟萃分析。《整合医学杂志》。2025；23(4)：370 - 381。
