Constipation and clinical outcomes in peritoneal dialysis: Results from Thailand PDOPPS - PubMed (original) (raw)

. 2023 Aug:28 Suppl 1:35-47.

doi: 10.1111/nep.14224.

Huttaporn Tharapanich 2, Jeerath Phannajit 3 4, Talerngsak Kanjanabuch 3 5 6, Athiphat Banjongjit 7, Pichet Lorvinitnun 8, Suchai Sritippayawan 9, Wichai Sopassathit 10, Ussanee Poonvivatchaikarn 11, Somphon Buranaosot 12, Wanida Somboonsilp 13, Pimpong Wongtrakul 13, Chanchana Boonyakrai 14, Surapong Narenpitak 15, Sajja Tatiyanupanwong 16, Wadsamon Saikong 17, Sriphrae Uppamai 18, Setthapon Panyatong 19, Rutchanee Chieochanthanakij 20, Niwat Lounseng 21, Angsuwarin Wongpiang 22, Worapot Treamtrakanpon 23, Peerapach Rattanasoonton 24, Narumon Lukrat 25, Phichit Songviriyavithaya 26, Uraiwan Parinyasiri 27, Piyarat Rojsanga 15, Patnarin Kanjanabuch 28, Pongpratch Puapatanakul 3 6, Krit Pongpirul 29 30 31 32, David W Johnson 33 34 35, Jeffrey Perl 36, Roberto Pecoits-Filho 37 38, Vuddhidej Ophascharoensuk 39, Kriang Tungsanga 3; Thailand PDOPPS Steering Committee

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Constipation and clinical outcomes in peritoneal dialysis: Results from Thailand PDOPPS

Guttiga Halue et al. Nephrology (Carlton). 2023 Aug.

Abstract

Background: Patient-reported outcome measures (PROMs) are widely recognized as valuable predictors of clinical outcomes in peritoneal dialysis (PD). Our study aimed to explore the connections between patient-reported constipation and clinical outcomes.

Methods: We assessed constipation in patients across 22 facilities participating in the Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) from 2014 to 2017. Constipation diagnosis utilized objective assessment tools such as the Bristol stool form scale (BSFS) and a self-reported questionnaire known as the constipation severity score (CSS). The BSFS is a 7-level scale that visually inspects feces based on texture and morphology, while the CSS measures constipation duration and severity using a 5-point Likert scale for various factors. We employed Cox proportional hazards model regression to determine the associations between constipation and clinical outcomes, including mortality, hemodialysis (HD) transfer and peritonitis.

Results: Among 975 randomly selected PD patients from 22 facilities, 845 provided written informed consent, and 729 completed CSS questionnaire. Constipation was prevalent in the PD population (13%), particularly among older patients, those who were caregiver dependent, had diabetes and poorer nutritional status (indicated by lower time-averaged serum albumin, potassium, creatinine and phosphate concentrations). Twenty-seven percent of which experiencing symptoms of constipation for over a year. Notably, self-reported constipation at baseline was significantly associated with a shorter time to first peritonitis and higher rates of peritonitis and death. However, no significant association was found between constipation and HD transfer after adjusting for various factors, including age, gender, PD vintage, comorbidities, shared frailty by study sites and serum albumin.

Conclusion: Patient-reported constipation independently correlated with increased risks of peritonitis and all-cause mortality, though no such correlation was observed with HD transfer. These findings underscore the need for further investigation to identify effective interventions for constipation in PD patients.

Keywords: Bristol stool form scale; PDOPPS; constipation; patient survival; peritonitis.

© 2023 Asian Pacific Society of Nephrology.

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References

REFERENCES

    1. Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Pract Res Clin Gastroenterol. 2011;25:3-18.
    1. Zuvela J, Trimingham C, Le Leu R, et al. Gastrointestinal symptoms in patients receiving dialysis: a systematic review. Nephrology (Carlton). 2018;23:718-727.
    1. Salmoirago-Blotcher E, Crawford S, Jackson E, Ockene J, Ockene I. Constipation and risk of cardiovascular disease among postmenopausal women. Am J Med. 2011;124:714-723.
    1. Honkura K, Tomata Y, Sugiyama K, et al. Defecation frequency and cardiovascular disease mortality in Japan: the Ohsaki cohort study. Atherosclerosis. 2016;246:251-256.
    1. Sumida K, Molnar MZ, Potukuchi PK, et al. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019;281:114-120.

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