Study uncovers link between constipation and kidney disease

Highlights

• Individuals with constipation had a 13% higher likelihood of developing chronic kidney disease and a 9% higher likelihood of developing kidney failure compared with individuals without constipation.

• More severe constipation was linked with an incrementally higher risk for both chronic kidney disease and kidney failure.

Washington, DC (November 10, 2016) -- Researchers have discovered a link between constipation and poor kidney health. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), suggest that the diagnosis and management of constipation might be helpful for preventing or treating kidney disease.

Constipation is a common condition, and it can have a variety of impacts on health. For example, constipation is known to increase individuals' risk of cardiovascular disease, potentially through effects caused by gut bacteria.

To investigate any possible association between constipation and kidney disease, Keiichi Sumida, MD and Csaba Kovesdy, MD (University of Tennessee Health Science Center and Memphis VA Medical Center) studied information on more than 3.5 million US veterans with normal kidney function who were initially examined in 2004 and 2006 and were followed through 2013.

Compared with patients without constipation, patients with constipation had a 13% higher likelihood of developing chronic kidney disease and a 9% higher likelihood of developing kidney failure, after adjusting for various patient characteristics. More severe constipation was linked with an incrementally higher risk for both chronic kidney disease and kidney failure.

"Our findings highlight the plausible link between the gut and the kidneys and provide additional insights into the pathogenesis of kidney disease progression," said Dr. Kovesdy. "Our results suggest the need for careful observation of kidney function trajectory in patients with constipation, particularly among those with more severe constipation." He added that if additional research reveals that constipation plays a causal role in kidney disease, treatment of constipation through lifestyle modifications and/or use of probiotics could potentially protect patients' kidney health.

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Study co-authors include Keiichi Sumida, MD; Miklos Molnar, MD, PhD; Praveen Potukuchi, MS; Fridtjof Thomas, PhD; Jun Ling Lu, MD; Kunihiro Matsushita, MD, PhD; Kunihiro Yamagata, MD, PhD; and Kamyar Kalantar-Zadeh, MD, PhD.

Disclosures: Drs. Kovesdy and Kalantar-Zadeh are employees of the US Department of Veterans Affairs. Opinions expressed in this paper are those of the authors and do not necessarily represent the opinion of the Department of Veterans Affairs. The study was funded by the National Institutes of Health (grant number R01 DK096920). None of the authors have relevant conflicts of interest.

The article, entitled "Constipation and Incident CKD," will appear online at http://jasn.asnjournals.org/ on November 10, 2016; doi: 10.1681/ASN.2016060656.

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