Constipation in chronic kidney disease (a quick, high-level DD)
Highlight: - The problem of constipation in CKD has long been underrecognized and its management strategies have scarcely been documented. - Constipation is highly prevalent in patients with chronic kidney disease (CKD) and is primarily characterized by decreased intestinal motility. - The pathogenesis of constipation in CKD patients is multifactorial: decreased physical activity, comorbidities affecting bowel movement, such as diabetes mellitus, cerebrovascular disease, and hyperparathyroidism, a restricted dietary intake of plant-based fiber-rich foods, and multiple medications, including phosphate binders and potassium-binding resins, have all been implicated. - Since constipation is often intractable, particularly in CKD patients, every available means needs to be employed in its treatment. - The chronic symptoms of constipation negatively affect patients’ quality of life and impose a considerable social and economic burden. - Recent epidemiological studies have revealed that constipation is independently associated with adverse clinical outcomes, such as end-stage renal disease (ESRD), cardiovascular (CV) disease, and mortality, potentially mediated by the alteration of gut microbiota and the increased production of fecal metabolites..