{"doi":"10.1093/ndt/gfaa205","title":"Laxative use in patients with advanced chronic kidney disease transitioning to dialysis","abstract":"BACKGROUND: Constipation is highly prevalent in patients with chronic kidney disease (CKD), particularly among those with end-stage renal disease (ESRD), partly due to their dietary restrictions, comorbidities and medications. Laxatives are typically used for constipation management; however, little is known about laxative use and its associated factors in patients with advanced CKD transitioning to ESRD. METHODS: In a retrospective cohort of 102 477 US veterans transitioning to dialysis between October 2007 and March 2015, we examined the proportion of patients who filled a prescription for any type of laxative within each 6-month period over 36 months pre- and post-transition to ESRD. Factors associated with laxative use during the last 1-year pre-ESRD period were identified by multivariable logistic regression. RESULTS: The proportion of patients prescribed laxatives increased as patients progressed to ESRD, peaking at 37.1% in the 6 months immediately following ESRD transition, then remaining fairly stable throughout the post-ESRD transition period. Among laxative users, stool softeners were the most commonly prescribed (∼30%), followed by hyperosmotics (∼20%), stimulants (∼10%), bulk formers (∼3%), chloride channel activator (<1%) and several combinations of these. The use of anticoagulants, oral iron supplements, non-opioid analgesics, antihistamines and opioid analgesics were among the factors independently associated with pre-ESRD laxative use. CONCLUSION: The use of laxatives increased considerably as patients neared transition to ESRD, likely mirroring the increasing burden of drug-induced constipation during the ESRD transition period. Findings may provide novel insight into better management strategies to alleviate constipation symptoms and reduce medication requirements in patients with advanced CKD.","journal":"Nephrology Dialysis Transplantation","year":2020,"id":104293,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9642,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":506815,"name":"Ankur A. Dashputre","orcid":"0000-0003-0898-959X","position":1,"is_corresponding":false},{"id":373697,"name":"Praveen K. Potukuchi","orcid":"0000-0003-0649-6089","position":2,"is_corresponding":false},{"id":371876,"name":"Fridtjof Thomas","orcid":"0000-0003-1325-4870","position":3,"is_corresponding":false},{"id":374672,"name":"Yoshitsugu Obi","orcid":"0000-0001-7032-4383","position":4,"is_corresponding":false},{"id":373698,"name":"Miklos Z. Molnar","orcid":"0000-0002-9665-330X","position":5,"is_corresponding":false},{"id":506816,"name":"Justin Gatwood","orcid":"0000-0002-4801-8555","position":6,"is_corresponding":false},{"id":244781,"name":"Elani Streja","orcid":"0000-0002-1261-0098","position":7,"is_corresponding":false},{"id":239168,"name":"Kamyar Kalantar‐Zadeh","orcid":null,"position":8,"is_corresponding":false},{"id":232670,"name":"Csaba P. Kövesdy","orcid":"0000-0002-8204-911X","position":9,"is_corresponding":false},{"id":506814,"name":"Keiichi Sumida","orcid":"0000-0002-2680-3173","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-18T22:43:22.755723Z","pmid":"33035325","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}