Associations between constipation symptoms and the sleep quality in non-dialysis chronic kidney disease patients: a cross-sectional study

Ruszkowski, Jakub; Heleniak, Zbigniew; Król, Ewa; Tarasewicz, Agnieszka; Witkowski, Jacek M.; Dębska‐Ślizień, Alicja

doi:10.20452/pamw.15974

Cited by 5 publications

(8 citation statements)

References 39 publications

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“…Additionally, Ramos et al suggested no association between dietary parameters and FC [ 40 ], while Ruszkowski et al showed that taking acetaminophen (paracetamol) was associated with higher, whereas non-steroidal anti-inflammatory drugs with lower, prevalence of FC [ 9 ]. Only one study explored (and found) relationships between the presence of FC and both HRQoL and sleep quality [ 9 , 46 ]. Ramos et al failed to prove a statistically significant association between reporting FC and having higher levels of p -cresyl sulfate, one of the uremic toxins that are generated by gut microbiota [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies provided data on the symptom implications ( Table S19 ). Briefly, Ruszkowski et al analyzed the associations between abdominal pain and both HRQoL and quality of sleep in CKD [ 9 , 46 ]. Miskulin et al questioned the association between either eGFR or height-adjusted total kidney volume and abdominal pain in ADPKD patients [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…Ruszkowski et al found that taking diuretics was independently associated with an increased prevalence of reporting type 1–2 (i.e., hard) stool form [ 9 ]. Interestingly, implications for HRQoL were explored in one study only: no associations between types 1–2 form and either HRQoL or sleep quality were found [ 9 , 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Lower GI symptoms, particularly abdominal bloating and self-reported constipation, are common in non-dialysis CKD patients, but their severity is limited. The literature showed the multiple relationships between lower GI symptoms and HRQoL, clinical outcomes, and laboratory data [ 9 , 23 , 35 , 39 , 40 , 46 , 49 , 50 , 51 , 52 , 53 ]. Our work is the first to analyze in detail the knowledge of lower GI symptomatology in non-dialysis-dependent CKD; thus, most likely for the first time, we demonstrated some novel findings that could not be concluded with sufficient certainty from the original studies (e.g., increased odds of self-reported constipation in CKD patients with more advanced disease).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

Ruszkowski

Majkutewicz

Heleniak

et al. 2022

JCM

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Chronic kidney disease (CKD) patients experience a wide range of symptoms that deteriorate their health-related quality of life (HRQoL). We aimed to estimate the prevalence and severity of lower gastrointestinal (GI) symptoms in non-dialysis CKD adult outpatients, and to summarize the relationships between these symptoms and HRQoL, laboratory test results, and clinical data. The protocol of the study was preregistered (PROSPERO CRD42021255122). We searched MEDLINE, Scopus, Web of Science, and grey literature sources from the databases’ inception up until 27 November 2021. Wide citation chasing was conducted. Single proportions (prevalence of functional constipation, self-reported constipation, diarrhea, abdominal bloating, fecal incontinence, and abdominal/rectal pain) were pooled using generalized linear mixed models. A total of 37 studies with 12,074 patients were included. We found that lower GI symptoms, especially self-reported abdominal bloating [CKD G1–2: 48.45% (95% CI: 43.5–53.4%; 2 studies); G3: 46.95% (95% CI: 45.0–48.9%; 2 studies), G4–5: 36.1% (95% CI: 25.4–48.5%; 8 studies)] and constipation [CKD G1–2: 31.8% (95% CI: 13.9–54.9%); G3: 29.8% (95% CI: 21.2–40.1%; 4 studies); G4–5: 38.8% (95% CI: 30.9–47.4%); 22 studies)], were common in non-dialysis CKD patients. The severity of the symptoms was limited. Self-reported constipation was most consistently associated with worse HRQoL, whereas hard stool consistency was associated with higher uremic toxins levels. To conclude, since lower GI symptoms are common in CKD, using symptom questionnaires that do not take them into account cannot provide full insight into the patient’s experience. Further studies are needed to cover identified knowledge gaps, including the exploration of the pathophysiology of GI symptoms in CKD with multi-omics data.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

Ruszkowski

Majkutewicz

Heleniak

et al. 2022

JCM

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“…Some inflammatory cytokines could affect sleep-wake regulation (32)(33)(34), while sleep deprivation increases inflammatory reactivity (35)(36)(37). The regression model adjusted for critical factors in a crosssectional study showed that constipation-related symptoms were independently associated with the incidence of sleep disorders (38). Moreover, different treatments and side effects of medications such as calcium channel blockers have impacts on sleep (39,40).…”

Section: Discussionmentioning

confidence: 99%

Association among sleep, depression, and health-related quality of life in patients with non-dialysis chronic kidney disease during the coronavirus disease 2019 pandemic

Chen¹,

Li²,

Zhang³

et al. 2022

Ann Palliat Med

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Background: Sleep disturbance is well documented as a crucial element that impairs health. Depression and health-related quality of life (HRQOL), which on behalf of a patient's overall perception of emotional, physical and social well-being, are increasingly emphasized self-reported health outcomes especially during the coronavirus disease 2019 (COVID-19) pandemic. Among dialysis patients, sleep disturbance is associated with depression and poorer HRQOL. The study was designed to depict the prevalence of sleep disturbance, and to explore the association among sleep, depression, and HRQOL in patients with non-dialysis chronic kidney disease (CKD) during the COVID-19 pandemic.Methods: A total of 172 non-dialysis CKD patients enrolled in this cross-sectional study, with sociodemographic and clinical data recorded. Sleep, HRQOL, and depression were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Kidney Disease Quality of Life 36-Item Short-Form Survey (KDQOL-36), and the 9-item Patient Health Questionnaire (PHQ-9), respectively.Results: A total of 100 (58%) met the criteria for poor sleep. Good sleepers had strikingly disparate HRQOL and depression scores compared to poor sleepers. Sleep disorders were significantly associated with decreased HRQOL and increased depression in regression models adjusted or unadjusted for sociodemographic and clinical characteristics. Mediation analysis indicated depression was a significant mediator explaining 51% of the relationship between sleep status with physical component summary (PCS) and played a fully mediating role in the association between sleep and mental component summary (MCS).Conclusions: Our study suggested the high incidence of sleep disorders in patients with non-dialysis CKD during the COVID-19 pandemic, as well as the tight associations among sleep, depression, and HRQOL.Considering the negative influences of sleep and depression on HRQOL, appropriate screening and treatment for these treatable health-related domains are necessary for patients with non-dialysis CKD.

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Factors associated with poor sleep quality in patients with pre‐dialysis chronic kidney disease: A systematic review

Huang

Cheng

Yen

2023

Journal of Advanced Nursing

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Aims: To determine factors associated with poor sleep quality among patients with pre-dialysis chronic kidney disease. Design: This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and checklist. Data Sources: Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. Review Methods: Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle-Ottawa Scale by two doctorial prepared nursing scientists.Results: A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal-related and cognitive arousal behaviours were associated with poor sleep quality. Conclusion: Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre-dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. Impact: Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self-management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease.

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Associations between constipation symptoms and the sleep quality in non-dialysis chronic kidney disease patients: a cross-sectional study

Cited by 5 publications

References 39 publications

Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis

Association among sleep, depression, and health-related quality of life in patients with non-dialysis chronic kidney disease during the coronavirus disease 2019 pandemic

Factors associated with poor sleep quality in patients with pre‐dialysis chronic kidney disease: A systematic review

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