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Constipation linked to kidney disease
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Constipation is associated with a 13% higher risk for chronic kidney disease and a 9% higher risk for kidney failure, and these risks share an incremental relationship with constipation severity, researchers found.
“Our findings highlight the plausible link between the gut and the kidneys and provide additional insights into the pathogenesis of kidney disease progression,” Csaba P. Kovesdy, MD, from the division of nephrology at University of Tennessee Health Science Center, and the Memphis VA Medical Center, said in a press release. “Our results suggest the need for careful observation of kidney function trajectory in patients with constipation, particularly among those with more severe constipation.”
Kovesdy and colleagues evaluated the association between constipation status/severity and incident chronic kidney disease (CKD), end-stage renal disease (ESRD) and change in estimated glomerular filtration rate (eGFR) in a nationally representative cohort of more than 3.5 million veterans with normal kidney function who were first examined in 2004 and 2006, and were then followed through 2013.
The overall cohort at baseline had a mean age of 60 years, 93.2% were men, 15.3% were black, 24.7% had diabetes and the mean eGFR was 83.8 ml/min per 1.73 m2. The 253,441 individuals who had constipation were older, more likely to be black, had a higher prevalence of comorbidities aside from HIV/AIDS, had lower per capita income and were less likely to be married.
Multivariable analyses showed patients with constipation had higher incidence rates of CKD (HR = 1.13; 95% CI, 1.11-1.14) and ESRD (HR = 1.09; 95% CI, 1.01-1.18). Constipation was also associated with progressive eGFR decline, and constipation severity was associated with incrementally increasing risks for each renal outcome.
Possible mechanisms for these associations may be tied to the gut microbiota or serotonin levels, the researchers suggested.
If further studies show a causal role of constipation in kidney disease, treating constipation with lifestyle interventions or probiotics could be protective of kidney health, Kovesdy noted in the press release. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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