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

: Aim:  Only few studies have reported that betel nut (BN) chewing is independently associated with chronic kidney disease (CKD); however, the sample size was relatively small. This study was to explore further the association between BN chewing and CKD using a larger case series. Methods:  We retrospectively reviewed the records of a health check-up program from 2003 to 2009. Laboratory tests, medical history and status of cigarette smoking, alcohol drinking and BN chewing were compared between CKD and non-CKD groups. We checked interaction effects between BN chewing and all other covariates, and conducted multivariate logistic regression analysis to explore the risk of CKD with BN chewing. Results:  A total of 27 482 participants (15 491 females and 11 991 males, mean age 58.02 ± 11.85 years) were included in the study, of whom 4519 (16.4%) had CKD and 1608 (5.9%) chewed BN. CKD prevalence in the chewers was higher than in the non-chewers in all age groups per decade. BN chewing was significantly associated with CKD in overall subjects (odds ratio (OR) = 1.23, P = 0.027) and also in the male (OR = 1.23, P = 0.035), non-drinking (OR = 1.62, P = 0.000), non-diabetic (OR = 1.27, P = 0.021), and non-proteinuric groups (OR = 1.30, P = 0.013). This relationship was insignificant in female, drinking, diabetic and proteinuric groups. Conclusion:  The association between BN chewing and CKD seemed conditional on demographics, health behaviours, and underlying co-morbidities. This association should be interpreted cautiously.