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Constipation and Incident CKD.

Keiichi Sumida1,2,3,4, Miklos Z Molnar1,5, Praveen K Potukuchi1

  • 1Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.

Journal of the American Society of Nephrology : JASN
|January 27, 2017
PubMed
Summary
This summary is machine-generated.

Constipation is linked to a higher risk of developing chronic kidney disease (CKD) and end-stage renal disease (ESRD). This study found that constipation severity correlates with increased risk and faster kidney function decline.

Keywords:
Epidemiology and outcomeschronic kidney diseaseend-stage renal diseaseglomerular filtration rate

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Epidemiology

Background:

  • Constipation is a common condition with known links to cardiovascular disease.
  • The association between constipation and chronic kidney disease (CKD) is not well understood.
  • Altered gut microbiota may mediate the link between constipation and systemic diseases.

Purpose of the Study:

  • To investigate the association between constipation status and severity and the risk of incident CKD, ESRD, and kidney function decline.
  • To examine these associations in a large cohort of United States veterans.

Main Methods:

  • A nationwide cohort of 3,504,732 US veterans with an estimated glomerular filtration rate (eGFR) ≥60 ml/min per 1.73 m² was analyzed.
  • Constipation status and severity were defined using diagnostic codes and laxative use.
  • Cox models and multinomial logistic regression models were used to assess the association with incident CKD, incident ESRD, and eGFR change.

Main Results:

  • Constipation was associated with higher incidence rates of CKD (HR, 1.13; 95% CI, 1.11-1.14) and ESRD (HR, 1.09; 95% CI, 1.01-1.18) compared to no constipation.
  • Patients with constipation experienced faster eGFR decline.
  • A dose-response relationship was observed, with more severe constipation associated with incrementally higher risks for renal outcomes.

Conclusions:

  • Constipation status and severity are independently associated with an increased risk of incident CKD and ESRD.
  • Constipation is linked to progressive decline in kidney function (eGFR).
  • Further research is needed to elucidate the underlying mechanisms connecting constipation and kidney disease.