Prevalence of constipation in continuous ambulatory peritoneal dialysis patients and comparison with hemodialysis patients.
ABSTRACT Many hemodialysis patients suffer from constipation. The frequency of constipation has not been rigorously evaluated in continuous ambulatory peritoneal dialysis (CAPD) patients, however. We conducted a survey on constipation in CAPD patients and compared the findings with those in hemodialysis patients through a questionnaire. Daily dietary fiber and potassium intake were calculated from the patients' dietary records. In the questionnaire, patients were asked about bowel frequency, stool consistency, straining, and use of laxatives and resins. The frequency of constipation was 28.9% in 204 CAPD patients and 63.1% in 268 hemodialysis patients. The hemodialysis patients had a 3.14 times higher relative risk of constipation than the CAPD patients. Only 3.4% of CAPD patients needed resin to avoid hyperkalemia. Of hemodialysis patients, 49% needed resin. Among the 261 hemodialysis patients, 205 (78.5%) suppressed an urge to defecate during hemodialysis therapy. Potassium and total dietary fiber intake per day were 1.8 +/- 0.5 g and 11.0 +/- 4.0 g in CAPD patients, which were higher (P < 0.01) than the values in hemodialysis patients--1.3 +/- 0.5 g and 5.9 +/- 2.7 g. The results suggest that constipation occurs less frequently in CAPD patients than in hemodialysis patients. The low rate of constipating drug administration, dialysis modality-based lifestyle, and higher total dietary fiber intake may cause the lower prevalence of constipation in CAPD patients.
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ABSTRACT: If access to effective palliative care is to extend beyond cancer patients, an understanding of the comparative prevalence of palliative care problems among cancer and non-cancer patients is necessary. This systematic review aimed to describe and compare the prevalence of seventeen palliative care-related problems across the four palliative care domains among adults with advanced cancer, acquired immune deficiency syndrome, chronic heart failure, end-stage renal disease (ESRD), chronic obstructive pulmonary disease, multiple sclerosis, motor neuron disease, Parkinson's disease, and dementia. Three databases were searched using three groups of keywords. The results of the extraction of the prevalence figures were summarized. The electronic searches yielded 4697 hits after the removal of 1784 duplicates. Of these hits, 143 met the review criteria. The greatest number of studies were found for advanced cancer (n=57) and ESRD patients (n=47), and 75 of the 143 studies used validated scales. Few data were available for people living with multiple sclerosis (n=2) and motor neuron disease (n=3). The problems with a prevalence of 50% or more found across most of the nine studied diagnostic groups were: pain, fatigue, anorexia, dyspnea, and worry. There are commonalities in the prevalence of problems across cancer and non-cancer patients, highlighting the need for palliative care to be provided irrespective of diagnosis. The methodological heterogeneity across the studies and the lack of non-cancer studies need to be addressed in future research.Journal of pain and symptom management 05/2014; · 2.42 Impact Factor
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ABSTRACT: To compare the prevalence and diversity of gastrointestinal (GI) symptoms in patients undergoing peritoneal dialysis (PD) and hemodialysis (HD).World journal of gastroenterology : WJG. 08/2014; 20(32):11370-5.
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ABSTRACT: The uremic milieu is consequential to a disrupted balance between availability of retention solutes and the excretory capacity of the kidneys. Although metabolism is the prime contributor to the internal milieu, a significant fraction of uremic retention solutes originates from other sources. The main route of entrance is via the intestinal tract, directly from the diet and indirectly from commensal microbial metabolism. This latter dynamic interplay between the intestines and kidney has been coined the gut–kidney axis. This review summarizes current understanding of the gut–kidney axis and explores the impact of dietary and other nonextracorporeal therapeutic interventions in patients with chronic kidney disease.Seminars in Nephrology 01/2014; 34(2):228–243. · 2.83 Impact Factor