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Constipation in Patients With Chronic Kidney Disease.
Ra Ri Cha1, Seon-Young Park2, Michael Camilleri3
1Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Gyeongsangnam-do, Korea.
Journal of Neurogastroenterology and Motility
|October 10, 2023
Summary
Constipation is common in chronic kidney disease (CKD) and can worsen kidney function. Specific treatments like lactulose, lubiprostone, linaclotide, plecanatide, tenapanor, and adjusted-dose prucalopride offer benefits for CKD patients with constipation.
Area of Science:
- Nephrology
- Gastroenterology
- Pharmacology
Background:
- Constipation is a prevalent issue for individuals with chronic kidney disease (CKD).
- It is linked to adverse health outcomes, including accelerated kidney function decline.
- Causes include medications, diet, and altered gut function in CKD patients.
Purpose of the Study:
- To review the mechanisms of constipation in CKD patients.
- To outline current and emerging management strategies for constipation in CKD.
- To provide a physician's perspective on treating constipation in this population.
Main Methods:
- Literature review of studies on constipation in chronic kidney disease.
- Analysis of the efficacy and safety of various pharmacological agents.
- Evaluation of non-pharmacological interventions and their impact.
Main Results:
- Standard laxatives may be ineffective or unsafe; some agents show promise.
- Lactulose, lubiprostone, linaclotide, plecanatide, and tenapanor demonstrate potential benefits and safety.
- Prucalopride may be effective but requires dose adjustment in CKD patients.
Conclusions:
- Constipation significantly impacts CKD patient health and kidney prognosis.
- Several novel agents offer improved efficacy and safety profiles for managing constipation in CKD.
- Personalized treatment strategies are crucial for optimizing outcomes in CKD patients with constipation.
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