Int J Med Sci 2020; 17(18):2954-2963. doi:10.7150/ijms.49648 This issue

Research Paper

Constipation and the Quality of Life in Conservatively Treated Chronic Kidney Disease Patients: A Cross-sectional Study

Jakub Ruszkowski1,2✉, Zbigniew Heleniak2, Ewa Król2, Agnieszka Tarasewicz2, Joanna Gałgowska2, Jacek M. Witkowski1, Alicja Dębska-Ślizień2

1. Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
2. Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland

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Citation:
Ruszkowski J, Heleniak Z, Król E, Tarasewicz A, Gałgowska J, Witkowski JM, Dębska-Ślizień A. Constipation and the Quality of Life in Conservatively Treated Chronic Kidney Disease Patients: A Cross-sectional Study. Int J Med Sci 2020; 17(18):2954-2963. doi:10.7150/ijms.49648. Available from https://www.medsci.org/v17p2954.htm

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Abstract

Background: Constipation is a common gastrointestinal disorder that in general population is associated with worse health-related quality of life (HRQoL). The epidemiology of constipation has not been reliably determined in conservatively-treated CKD patients. We aimed to determine the prevalence of constipation and constipation-related symptoms in conservatively-treated CKD patients, to find factors associated with their altered prevalence ratio (PR), and to verify the associations between constipation and HRQoL.

Methods: In this cross-sectional study, 111 conservatively-treated CKD outpatients fulfilled questionnaires that included questions addressing HRQoL (SF-36v2®), constipation-related symptoms (The Patient Assessment of Constipation‐Symptoms questionnaire), the Bristol stool form scale (BSFS), Rome III criteria of functional constipation (FC), and frequency of bowel movement (BM).

Results: Depending on the used definition, the prevalence of constipation was 6.6-28.9%. Diuretics and paracetamol were independently associated with increased PR of BSFS-diagnosed constipation (PR 2.86, 95% CI 1.28-6.37, P = 0.01) and FC (PR 2.67, 95% CI 1.07-6.64, P = 0.035), respectively. The most commonly reported symptoms were bloating (50.9%) and straining to pass a BM (42.7%). Abdominal discomfort (37.3%) was independently associated with worse scores in all analyzed HRQoL domains. In multiple regressions, FC and having <7 BM/week, but not BSFS-diagnosed constipation, were associated with lower scores in several HRQoL domains.

Conclusions: Constipation and related symptoms are prevalent in CKD patients. FC and decreased frequency of defecation, but not BSFS-diagnosed constipation, are associated with worse assessment of HRQoL in conservatively-treated CKD patients.

Keywords: chronic kidney disease, constipation, flatulence, SF-36v2