Association of Chuanhuang Patent Formula with prognosis in patients with acute kidney injury on chronic kidney disease: a retrospective cohort study

This study evaluated the association of Chuanhuang Patent Formula (CHPF) with short-term renal function parameters and long-term prognosis in patients with acute kidney injury (AKI) on chronic kidney disease (CKD) (A on C) and explored potential subgroups that might derive greater benefit. This retrospective cohort included 205 patients with A on C admitted between January 2016 and October 2025. After 1:1 propensity score matching, 81 patients were included in each group. The primary composite outcome was progression to CKD stage 5, maintenance renal replacement therapy initiation, or all-cause mortality, while secondary outcomes evaluated renal function parameters at 2 and 4 weeks. Renal function parameters were more favorable in the CHPF group at 2 and 4 weeks after treatment initiation. Long-term survival analysis showed that CHPF treatment was associated with a lower risk of the primary outcome (hazard ratio [HR] = 0.56; 95% confidence interval [CI]: 0.32–0.98; p = 0.041). Notably, hypertension-stratified subgroup analysis showed that the association between CHPF treatment and outcome-free survival appeared more evident in patients with comorbid hypertension (p = 0.045), whereas no significant difference was observed in patients without hypertension (p = 0.26). In conclusion, CHPF could be a promising adjunctive therapeutic strategy for patients with A on C and was associated with more favorable 2- and 4-week renal function parameters and long-term outcome-free survival. Patients with comorbid hypertension might represent a potential subgroup that could derive greater benefit from CHPF treatment; however, this exploratory finding should be interpreted cautiously and validated in prospective studies.