Association of betel nut chewing with chronic kidney disease: A retrospective 7‐year study in Taiwan

Hsu, Yuan-Yu; Liu, Wen-Hsin; Chen, Wei; Kuo, Yi‐Chun; Hsiao, Chih‐Yen; Hung, Peir-Haur; Jong, Ing-Ching; Chiang, Pei-Chun; Hsu, Chih‐Cheng

doi:10.1111/j.1440-1797.2011.01489.x

Cited by 16 publications

(21 citation statements)

References 23 publications

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“…Second, we used gender-stratified analysis to document the different effects of alcohol drinking on CKD in men and women. In addition, previous research indicated that anemia, hyperuricemia, and BN chewing were associated with CKD [20,38-40], so we adjusted for these confounders in our multivariable analysis. Besides, we conducted a series of sensitivity tests to remove impacts of reverse causality.…”

Section: Discussionmentioning

confidence: 99%

“…Detailed description and definitions of variables in the dataset were described previously [20]. Briefly, from 2003 to 2009, 34 372 people who attended a national health insurance sponsored health check-up program in Ditmanson Medical Foundation Chia-Yi Christian Hospital, were selected as study subjects.…”

Section: Methodsmentioning

confidence: 99%

“…The prevalence of BN chewing in Taiwanese men was reported to be over 28% [19]. Most Taiwanese people who chew BN also consume alcohol and cigarettes [20]. BN chewing was reported to be associated with CKD and proteinuria in Taiwanese population [20,21].…”

Section: Introductionmentioning

confidence: 99%

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Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men

et al. 2013

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BackgroundChronic kidney disease (CKD) is a major global public health burden, but there is limited understanding of the relationship of alcohol consumption with CKD.MethodsIn this cross-sectional multivariable study, all participants of a health check-up program in Ditmanson Medical Foundation Chia-Yi Christian Hospital in Taiwan from 2003 to 2009 (15 353 women and 11 900 men) were included for analysis. Estimated glomerular filtration rate was used to define CKD stage and history of alcohol consumption was obtained by self-reporting. Multivariable logistic regression analyses of gender-specific association of alcohol drinking with stage 3 CKD were conducted. A trend tests was conducted to check the dose–response relationship of alcohol consumption with renal disease. A sensitivity test was conducted to rule out the likelihood of reverse causality.ResultsThe prevalence of stage 3 CKD was lower in drinkers than non-drinkers (p < 0.001) and the percentage of drinkers with stage 3 CKD was less than that of non-drinkers. Multivariable analysis indicated that alcohol consumption was negatively associated with the presence of stage 3 CKD in men (adjusted odds ratio [aOR] for occasional drinking: 0.68, 95% CI: 0.59 ~ 0.78, p < 0.001; aOR for frequent drinking: 0.47, 95% CI: 0.35 ~ 0.63, p < 0.001). Advanced age, hypertension, anemia, BMI of at least 24, hyperuricemia, and proteinuria were also associated with stage 3 CKD in men. Trend tests indicated lower odds of having stage 3 CKD with increased alcohol consumption in both genders. Subgroup analyses and sensitivity tests also indicated the reverse association between alcohol consumption and stage 3 CKD in men regardless of age, diabetes status, and other risky behaviors.ConclusionsAlcohol consumption was inversely associated with stage 3 CKD in Taiwanese men. However, considering the potential of other health damage with alcohol consumption, the current results should be interpreted cautiously.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men

et al. 2013

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“…To reduce the rate of betel nut consumption, other than through education and health promotion programmes, strategies have been devised to encourage physical activity and oral hygiene 17. Another strategy includes fines and mandatory withdrawal classes for those who spit in public 18. According to another study, an effective approach would be to apply taxes on wholesalers who are easily identifiable and who make the greatest profit from the industry 2.…”

Section: Bioethical Reflectionsmentioning

confidence: 99%

The ethics of betel nut consumption in Taiwan

et al. 2017

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The ethics of betel nut use in Taiwan are examined in this article. It first presents scientific facts about the betel quid, its consumption and negative health consequences and then analyses the cultural background and economic factors contributing to its popularity in Asia. Governmental and institutional attempts to curb betel nut cultivation, distribution and sales are also described. Finally, the bioethical implications of this often ignored subject are considered.

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“…A higher rate of concurrent usage of oral substances, particularly in the CKD group, indicates certain lifestyle patterns, which may confer a higher health risk [41]. However, previous studies demonstrated an inverse association between alcohol consumption and renal dysfunction [42], [43] because beneficial oxidative activity on endothelial function has a protective property for kidneys [42], [44]. Additionally, in Taiwan, CKD prevalence among betel-nut users is higher than in the non-users in all age groups [43].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Case-Control Analysis of the Outpatient Expenditures for Western Medicine and Dental Treatment Modalities in CKD Patients in Taiwan

et al. 2014

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BackgroundTo determine if expenditures for dentistry (DENT) correlate with severity of chronic kidney disease (CKD).MethodsA total of 10,457 subjects were enrolled from January 2008 to December 2010, divided into three groups: healthy control (HC) group (n = 1,438), high risk (HR) group (n = 3,392), and CKD group (n = 5,627). Five stages were further categorized for the CKD group. OPD utilization and expenditures for western medicine (WM), DENT, and TCM (traditional Chinese medicine) were analyzed retrospectively (2000–2008) using Taiwan's National Health Insurance Research Database. Three major areas were analyzed among groups CKD, HR and HC in this study: 1) demographic data and medical history; 2) utilization (visits/person/year) and expenditures (9-year cumulative expenditure, expenditure/person/year) for OPD services in WM, DENT, and TCM; and 3) utilization and expenditures for dental OPD services, particularly in dental filling, root canal and periodontal therapy.ResultsOPD utilization and expenditures of WM increased significantly for the CKD group compared with the HR and HC groups, and increased steadily along with the severity of CKD stages. However, overall DENT and TCM utilization and expenditures did not increase for the CKD group. In comparison among different CKD stages, the average expenditures and utilization for DENT including restorative filling and periodontal therapy, but not root canal therapy, showed significant decreases according to severity of CKD stage, indicating less DENT OPD utilization with progression of CKD.ConclusionsPatients with advanced CKD used DENT OPD service less frequently. However, the connection between CKD and DENT service utilization requires further study.

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Association of betel nut chewing with chronic kidney disease: A retrospective 7‐year study in Taiwan

Abstract: The association between BN chewing and CKD seemed conditional on demographics, health behaviours, and underlying co-morbidities. This association should be interpreted cautiously.

Cited by 16 publications

References 23 publications

Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men

Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men

The ethics of betel nut consumption in Taiwan

A Retrospective Case-Control Analysis of the Outpatient Expenditures for Western Medicine and Dental Treatment Modalities in CKD Patients in Taiwan

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