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Abstract: TH-PO384

The Effect of Traditional Chinese Medicine (TCM) Practice on Mortality Risk in a Large Cohort of Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) from China

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis


  • Ming, Pei, First teaching hospital of Tianjin university of TCM, Tianjin, China, Tianjin, TIANJIN , China
  • Marshall, Mark R., Middlemore Hospital, Auckland, New Zealand
  • Li, Haiming, Baxter China, Shanghai, China
  • Feng, Tao, Baxter (China) Investment Co., Ltd, Guangzhou, China
  • Yao, Qiang, Baxter, Shanghai, China
  • Yang, Hongtao, First teaching hospital of Tianjin university of TCM, Tianjin, China, Tianjin, TIANJIN , China

We report mortality risk in a cohort of patients on CAPD from China, comparing outcomes between hospitals classified as TCM hospitals versus conventional ones.


Data were sourced from the Baxter Healthcare (China) support program database, comprising an inception cohort commencing PD between Jan-2005 and September-2015, followed until death, dropout, loss to follow-up, or November-2015, whichever occurred first. The primary outcome was death. The primary exposure was official classification of the treating hospital as TCM versus conventional, although we separated TCM further according to whether the hospital was affiliated with the China TCM PD Federation (TCM-PDF) or not. We made comparison using Cox proportional hazards models with shared frailty by center, censoring for kidney transplantation and change to HD, adjusting for age, gender, employment, insurance, primary renal disease, size of PD program .


We modelled 100,558 subjects from 1,134 centres over 241,051patient-years. CAPD patients at TCM hospitals were younger, more likely female, with hypertension as kidney disease, urban, unemployed, from larger programs, and treated with < 4 exchanges per day. The modelling results are presented in Table 1.


TCM is associated with better outcomes for PD patients in China. TCM interventions include traditional diet therapy optimizing digestive tract symptoms and therefore nutrition, traditional medications to increase urinary volume and ameliorate the micro-inflammatory state, the use of enemas to reduce accumulation of uremic toxins and maintain bowel habit, and traditional Wu Style Tai Chi Chuan athletics. However, the indentified benefit with TCM appears to be restricted to hospital with an affiliation with the TCM-PDF, and we believe this is due to greater standardization of management, and a greater focus on continuing medical education and scholarly activities in affiliated centers.

Hospital groupSub-groupnHazard ratio for death95% confidence intervals
Conventional 79,696RefRef
TCMAll7,4870.870.76, 0.98
 TCM-PDF2,4840.960.82, 1.14
 TCM-only5,0030.770.66, 0.91


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