ArticleBMC nephrology2021
Laxative use and mortality in patients on haemodialysis: a prospective cohort study.
Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between constipation and risk of cardiovascular or all-cause mortality: a meta-analysis.Annals of medicine · 2025Pooled it
- Tenapanor Beyond Phosphate: Gut Sodium Transport, Stool Transit Time, and Volume Balance in Dialysis Patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Review
- Association between Phosphate Binders and Constipation in Patients Undergoing Chronic Hemodialysis: A Cross-sectional Study.Internal medicine (Tokyo, Japan) · 2026Article
- Tenapanor: A novel therapeutic agent for dialysis patients with hyperphosphatemia.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2025Review
- Insomnia, pruritus, and constipation in hemodialysis patients: a cross-sectional study.Frontiers in physiology · 2025Article
- Constipation and risk of death and cardiovascular events in patients on hemodialysis.Kidney research and clinical practice · 2025Article
- Effects of salt reduction education from a salt questionnaire on inter-dialysis weight gain in patients on hemodialysis.Clinical and experimental nephrology · 2024Article
- Intestinal microbiome changes and mechanisms of maintenance hemodialysis patients with constipation.Frontiers in cellular and infection microbiology · 2024Article
- Gutted: constipation in children with chronic kidney disease and on dialysis.Pediatric nephrology (Berlin, Germany) · 2023Review
- Relation between laxative use and risk of major bleeding in patients with atrial fibrillation and heart failure.Heart and vessels · 2023Article
- Contact Laxative Use and the Risk of Arteriovenous Fistula Maturation Failure in Patients Undergoing Hemodialysis: A Multi-Center Cohort Study.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients on haemodialysis (HD) are often constipated. This study aimed to assess the relationship between constipation and mortality in such patients. In this study, constipation was defined as receiving prescription laxatives, based on the investigation results of "a need to take laxatives is the most common conception of constipation" reported by the World Gastroenterology Organization Global Guidelines.
methodsThis cohort study included 12,217 adult patients on HD enrolled in the Japan-Dialysis Outcomes and Practice Patterns study phases 1 to 5 (1998 to 2015). The participants were grouped into two based on whether they were prescribed laxatives during enrolment at baseline. The primary endpoint was all-cause mortality in 3 years, and the secondary endpoint was cause-specific death. Missing values were imputed using multiple imputation methods. All estimations were calculated using a Cox proportional hazards model with an inverse probability of treatment weighting using the propensity score.
resultsLaxatives were prescribed in 30.5% of the patients, and there were 1240 all-cause deaths. There was a significant association between laxative prescription and all-cause mortality [adjusted hazard ratio (AHR), 1.12; 95% confidence interval (CI): 1.03 to 1.21]. Because the Kaplan-Meier curves of the two groups crossed over, we examined 8345 patients observed for more than 1.5 years. Laxative prescription was significantly associated with all-cause mortality (AHR, 1.35; 95% CI: 1.17 to 1.55). The AHR of infectious death was 1.62 (95% CI: 1.14 to 2.29), and that of cancerous death was 1.60 (95% CI: 1.08 to 2.36). However, cardiovascular death did not show a significant inter-group difference.
conclusionsConstipation requiring use of laxatives was associated with an increased risk of death in patients on HD. It is important to prevent patients receiving HD from developing constipation and to reduce the number of patients requiring laxatives.
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