Laxative use and acute kidney injury risk: Analysis of a Japanese hospital-based database

Although a potential association between laxative use and the development of acute kidney injury (AKI) has been proposed, it remains inadequately investigated. Therefore, the objective of this study was to elucidate the association between the use of each laxative and the risk of developing AKI. Data were obtained from the JMDC hospital-based administrative claims database, covering the period from April 2014 to August 2022. Laxatives were defined as lubiprostone and linaclotide (secretory drugs), senna (a stimulant), and magnesium oxide (a nonabsorbed substance). AKI was defined in accordance with the recommendations of the Kidney Disease: Improving Global Outcomes working group. After screening, 159,630 patients were eligible for inclusion. AKI occurred in 693 patients (94/1000 patient-years) in the magnesium oxide group, 67 (153/1000 patient-years) in the lubiprostone group, 194 (109/1000 patient-years) in the senna group, and 22 (161/1000 patient-years) in the linaclotide group. Cox regression analysis revealed that the use of lubiprostone (adjusted hazard ratio, 0.96; 95% CI, 0.74-1.24), senna (adjusted hazard ratio, 1.08; 95% CI, 0.91-1.27), and linaclotide (adjusted hazard ratio, 1.42; 95% CI, 0.92-2.17) did not decrease the risk of AKI compared with magnesium oxide. The findings suggest that there is no difference in AKI risk among the various laxatives studied. SIGNIFICANCE STATEMENT: The results indicate that there were no differences in the risk of acute kidney injury among lubiprostone, linaclotide, senna, and magnesium oxide, suggesting that the use of these laxatives might not impact the risk of acute kidney injury.