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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Creation of a Natural Health Products Database for Assessing Safety for Patients with Chronic Kidney Disease or Renal Transplant
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Creation of a Natural Health Products Database for Assessing Safety for Patients with Chronic Kidney Disease or Renal Transplant

机译：创建天然保健品数据库，用于评估慢性肾疾病或肾移植患者的安全性

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Introduction: There is a lack of published safety information on the use of natural health products (NHPs) for patients with chronic kidney disease (CKD) or renal transplant. Objective: To create an online database to provide evidence-based safety recommendations for commonly used NHPs, specific to patients with CKD or renal transplant. Methods: NHPs used by CKD and transplant patients in British Columbia were identified from the records of the BC Provincial Renal Agency. For each NHP, several databases (MEDLINE, Embase, Lexi-Natural Products, PubMed Dietary Supplement Subset, and Natural Medicines) were searched for any information pertaining to dosage, adverse drug reactions, drug interactions, immunomodulatory effects, and pharmacokinetics in patients with renal disease. Each NHP was given 1 of 4 safety ratings: likely safe, possibly safe, possibly unsafe, and likely unsafe. An NHP was classified as "possibly unsafe" for patients with renal transplant if it had demonstrated in vitro immunomodulatory effects and/or significant interactions with transplant medications due to effects on the cytochrome P450 3A4 isozyme. Results: Of the 19 627 BC-registered patients with renal disease (as of August 2014), 4122 (21%) were using one or more NHPs. The Herbal-CKD website (www.herbalckd.com) was created in 2015 to provide information about 47 commonly used NHPs and 2 known nephrotoxins (aristolochic acid and silver). This website provides a systematic evaluation of safety information for selected NHPs for patients with CKD (both nondialysis and dialysis-dependent) and kidney transplant. The most common NHP safety classification was "possibly safe", reflecting the paucity of studies in renal populations and the availability of safety data for the general population. Limitations of the website include difficulty in interpreting and generalizing the safety literature because most NHP formulations are not standardized, and others are combination products. Conclusion: The website www.herbalckd.com provides an easy-to-use, evidence-based tool for health care professionals to assess the safety of NHPs for CKD and transplant patients.
机译：导言：关于慢性肾病（CKD）或肾移植患者使用天然健康产品（NHPs）的安全性，目前还缺乏公开的信息。目的：建立一个在线数据库，为常见的NHP提供循证安全建议，特别是CKD或肾移植患者。方法：不列颠哥伦比亚省CKD和移植患者使用的NHP来自不列颠哥伦比亚省肾脏机构的记录。对于每一个NHP，都要搜索多个数据库（MEDLINE、Embase、Lexi天然产品、PubMed膳食补充剂子集和天然药物），以查找与剂量、药物不良反应、药物相互作用、免疫调节作用和肾病患者药代动力学有关的任何信息。每个NHP都有四个安全等级中的一个：可能安全、可能安全、可能不安全和可能不安全。如果NHP由于对细胞色素P450 3A4同功酶的影响而显示出体外免疫调节作用和/或与移植药物的显著相互作用，则被归类为肾移植患者的“可能不安全”。结果：在19627名BC登记的肾病患者中（截至2014年8月），4122名（21%）正在使用一种或多种NHP。草药CKD网站（www.herbalckd.com）创建于2015年，提供47种常用NHP和2种已知肾毒素（马兜铃酸和银）的信息。本网站为CKD（非透析和透析依赖性）和肾移植患者提供所选NHP安全性信息的系统评估。最常见的NHP安全性分类为“可能安全”，反映了肾脏人群研究的匮乏和普通人群安全性数据的可用性。该网站的局限性包括难以解释和概括安全性文献，因为大多数NHP配方未标准化，其他配方为混合产品。结论：网站www.herbalckd。com为卫生保健专业人员提供了一个易于使用的循证工具，用于评估慢性肾病和移植患者NHP的安全性。

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