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Laxative use in patients with advanced chronic kidney disease transitioning to dialysis.
- Source :
- Nephrology Dialysis Transplantation; Nov2021, Vol. 36 Issue 11, p2018-2026, 9p
- Publication Year :
- 2021
-
Abstract
- Background Constipation is highly prevalent in patients with chronic kidney disease (CKD), particularly among those with end-stage renal disease (ESRD), partly due to their dietary restrictions, comorbidities and medications. Laxatives are typically used for constipation management; however, little is known about laxative use and its associated factors in patients with advanced CKD transitioning to ESRD. Methods In a retrospective cohort of 102 477 US veterans transitioning to dialysis between October 2007 and March 2015, we examined the proportion of patients who filled a prescription for any type of laxative within each 6-month period over 36 months pre- and post-transition to ESRD. Factors associated with laxative use during the last 1-year pre-ESRD period were identified by multivariable logistic regression. Results The proportion of patients prescribed laxatives increased as patients progressed to ESRD, peaking at 37.1% in the 6 months immediately following ESRD transition, then remaining fairly stable throughout the post-ESRD transition period. Among laxative users, stool softeners were the most commonly prescribed (∼30%), followed by hyperosmotics (∼20%), stimulants (∼10%), bulk formers (∼3%), chloride channel activator (<1%) and several combinations of these. The use of anticoagulants, oral iron supplements, non-opioid analgesics, antihistamines and opioid analgesics were among the factors independently associated with pre-ESRD laxative use. Conclusion The use of laxatives increased considerably as patients neared transition to ESRD, likely mirroring the increasing burden of drug-induced constipation during the ESRD transition period. Findings may provide novel insight into better management strategies to alleviate constipation symptoms and reduce medication requirements in patients with advanced CKD. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09310509
- Volume :
- 36
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Nephrology Dialysis Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 153558595
- Full Text :
- https://doi.org/10.1093/ndt/gfaa205