Health-related quality of life in dialysis patients with constipation: a cross-sectional study

Zhang, Jisheng; Huang, Chen; Li, Yanli; Chen, Jun; Shen, Fang-Yuan; Yao, Qiang; Qian, Jiaqi; Bao, Bin; Yao, Xuping

doi:10.2147/ppa.s45471

Cited by 23 publications

(38 citation statements)

References 39 publications

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“…We have demonstrated that FC is independently associated with BP and VT, parts of SF-36v2 physical and mental summary components, respectively. Similarly, Zhang et al have shown that FC is associated with lower scores in both physical and mental summary components of HRQoL in both HD and PD patients 17 . Interestingly, our study has indicated that constipation diagnosed with BSFS is not associated with worse HRQoL in conservatively-treated CKD patients.…”

Section: Discussionmentioning

confidence: 83%

“…Among all GI symptoms, constipation is the most frequently assessed GI symptom in dialysis patients, and the prevalence of constipation is higher in hemodialysis (HD) patient than in peritoneal dialysis (PD) patients (23.8-71.7% vs 14.2-28.9% of patients, respectively) 16 . In dialysis patients, like in a general population, constipation is associated with worse HRQoL 17 .…”

Section: Introductionmentioning

confidence: 99%

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

Ruszkowski¹,

Heleniak²,

Król³

et al. 2020

Int. J. Med. Sci.

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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.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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

Ruszkowski¹,

Heleniak²,

Król³

et al. 2020

Int. J. Med. Sci.

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“…The full texts of the remaining 80 articles were retrieved and assessed for eligibility. A total of 35 articles were excluded for the following reasons: comparison group other than in-center HD, 48 , 49 , 50 groups were not separately presented, 51 , 52 , 53 , 54 , 55 unspecified HRQoL questionnaire, 56 , 57 , 58 , 59 HRQoL data exclusively presented in graphs, 60 , 61 , 62 unclear calculation of HRQoL scores, 63 , 64 and outdated population data (data collected before 2007). 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 The studies of Garg et al 17 (Frequent Hemodialysis Network trials) and Jardine et al 81 (ACTIVE dialysis trial) were excluded because they focused on frequent HD that was not exclusively performed at home.…”

Section: Resultsmentioning

confidence: 99%

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

et al. 2020

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Rationale & Objective Dialysis patients judge health-related quality of life (HRQoL) as an essential outcome. Remarkably, little is known about HRQoL differences between home dialysis and in-center hemodialysis (HD) patients worldwide. Study Design Systematic review and meta-analysis. Setting & Study Populations Search strategies were performed on the Cochrane Library, Pubmed, and EMBASE databases between 2007 and 2019. Home dialysis was defined as both peritoneal dialysis and home HD. Selection Criteria for Studies Randomized controlled trials and observational studies that compared HRQoL in home dialysis patients versus in-center HD patients. Data Extraction The data extracted by 2 authors included HRQoL scores of different questionnaires, dialysis modality, and subcontinent. Analytical Approach Data were pooled using a random-effects model and results were expressed as standardized mean difference (SMD) with 95% CIs. Heterogeneity was explored using subgroup analyses. Results Forty-six articles reporting on 41 study populations were identified. Most studies were cross-sectional in design (90%), conducted on peritoneal dialysis patients (95%), and used the 12-item or 36-item Short-Form Health Survey questionnaires (83%). More than half the studies showed moderate or high risk of bias. Pooled analysis of 4,158 home dialysis patients and 7,854 in-center HD patients showed marginally better physical HRQoL scores in home dialysis patients compared with in-center HD patients (SMD, 0.14; 95% CI, 0.04 to 0.24), although heterogeneity was high ( I 2 >80%). In a subgroup analysis, Western European home dialysis patients had higher physical HRQoL scores (SMD, 0.39; 95% CI, 0.17 to 0.61), while home dialysis patients from Latin America had lower physical scores (SMD, −0.20; 95% CI, −0.28 to −0.12). Mental HRQoL showed no difference in all analyses. Limitations No randomized controlled trials were found and high heterogeneity among studies existed. Conclusions Although pooled data showed marginally better physical HRQoL for home dialysis patients, the quality of design of the included studies was poor. Large prospective studies with adequate adjustments for confounders are necessary to establish whether home dialysis results in better HRQoL. Trial Registration PROSPERO 95985.

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“…27 Insoluble fiber supplementation and its laxation effect may be of significant benefit to those in later stages CKD, particularly those on dialysis. 28 No further increase in stool frequency was observed with inulin supplementation. Although increased stool frequency has been reported with inulin 29 and oligofructose, 30 the expected increase would be small and likely masked by the significant effect of the pea hull fiber.…”

Section: Discussionmentioning

confidence: 96%

Fiber Supplementation Lowers Plasma p-Cresol in Chronic Kidney Disease Patients

Salmean

Segal

Palii

et al. 2015

Journal of Renal Nutrition

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Objective To determine the effects of supplemental fiber on plasma p-cresol, stool frequency, and quality of life (QoL) in chronic kidney disease (CKD) patients. Design and Setting In a 12-week single-blind study, participants were provided with control muffins and supplements (5.5 g sucrose/day) for 2 weeks, muffins containing 10 g/day pea hull fiber and control supplements for 4 weeks, and muffins with 10 g/day pea hull fiber and 15 g/day inulin as a supplement for 6 weeks. Subjects Individuals with CKD (n = 13; 6 males, 7 females; aged 65 ± 3 years; estimated glomerular filtration rate <50 mL/minute/1.732) completed the study. Main Outcome Measures Plasma p-cresol was determined by gas chromatography-mass spectrometry, stool frequency by 5-day journals, and QoL by the KDQOL-36™. Results Plasma p-cresol decreased from 7.25 ± 1.74 mg/L during week 1 to 5.82 ± 1.72 mg/L during week 12 (P < .05), and in participants with high compliance (>70% inulin intake), from 6.71 ± 1.98 mg/L to 4.22 ± 1.16 mg/L (P < .05). Total fiber intake increased from 16.6 ± 1.7 g/day during control to 26.5 ± 2.4 g/day (P < .0001) with the added pea hull and to 34.5 ± 2.2 g/day with pea hull and inulin (P < .0001). Stool frequency increased from 1.4 ± 0.2 stools/day during control to 1.9 ± 0.3 stools/day during both fiber periods (P < .05). No change in overall QoL was observed. Conclusions Supplementing the diet of CKD patients with fiber may be a dietary therapy to reduce p-cresol and improve stool frequency.

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Health-related quality of life in dialysis patients with constipation: a cross-sectional study

Cited by 23 publications

References 39 publications

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

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

Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis

Fiber Supplementation Lowers Plasma p-Cresol in Chronic Kidney Disease Patients

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