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.
SourceAvailable from: Fatih Mehmet Erdur[Show abstract] [Hide abstract]
ABSTRACT: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in chronic kidney disease (CKD) patients receiving hemodialysis (HD). Oxalic acid is a uremic retention molecule that has been extensively studied in the pathogenesis of calcium-oxalate stones. Oxalobacter formigenes (O. formigenes), a component of the colonic microbiota, plays an important role in oxalate homeostasis. Little is known regarding the colonization of HD patients by O. formigenes and the exact role of this bacterial species in oxalic acid metabolism in these patients. We hypothesized that oxalic acid may be insufficiently degraded in HD patients due to under colonization of the colon by O. formigenes in these patients. To test this hypothesis, we sought to quantitatively measure fecal O. formigenes levels and serum oxalic acid levels in HD patients. We also suggest that increased oxalic acid levels may be associated with endothelial dysfunction and aortic stiffness, both of which are commonly observed in HD patients. Increased colonization with O. formigenes via the ingestion of prebiotics and probiotics could potentially decrease serum oxalic acid levels and improve cardiovascular outcomes in HD patients. Copyright © 2015 Elsevier Ltd. All rights reserved.Medical Hypotheses 01/2015; DOI:10.1016/j.mehy.2015.01.010 · 1.15 Impact Factor
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ABSTRACT: The current study aim of this study was to assess the safety and probability of adverse events associated with the use of 75mg pregabalin post hemodialysis (pHD) among patients with UP.Saudi Pharmaceutical Journal 01/2015; 99. DOI:10.1016/j.jsps.2014.10.004 · 1.00 Impact Factor
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ABSTRACT: Objectives To evaluate the effects of olive oil and flaxseed oil compared with mineral oil for the treatment of constipation in patients undergoing hemodialysis. Methods A 4-week, double-blind, randomized, and controlled trial was conducted. Fifty constipated patients (29% male, 51 ± 12 years) diagnosed by the Rome III criteria were randomly assigned to receive mineral oil (control group; n = 17), olive oil (n = 16), or flaxseed oil (n = 17). The initial oil dose was 4 mL/day, and adjustments during the follow-up could be made as needed. The impact of the intervention was assessed by the Rome III criteria scores. Results The most frequent symptoms of constipation evaluated by the Roma III criteria at baseline were comparable among the groups and included “incomplete evacuation” (92%), “lumpy or hard stools,” (72%) and “anorectal obstruction” (70%). The Rome III score improved significantly in patients receiving mineral oil (10.5 ± 5.0 to 4.1 ± 4.0; P < .01), olive oil (10.3 ± 4.2 to 3.2 ± 3.8; P = .01), and flaxseed oil (9.6 ± 4.2 to 6.0 ± 5.1; P < .01), with no significant group-by-time interaction (P = .15). The scores of 5 from 6 constipation symptoms reduced similarly in the mineral oil and olive oil groups, whereas only the frequency of evacuation and the consistency of stools improved in the flaxseed oil group. Conclusions We demonstrated that the daily use of olive oil or flaxseed oil was as effective as mineral oil in the treatment of constipation in patients undergoing hemodialysis.Journal of Renal Nutrition 09/2014; 25(1). DOI:10.1053/j.jrn.2014.07.009 · 1.75 Impact Factor