AI Article Synopsis
- Functional constipation is common in healthy children but poses additional risks for those with chronic kidney disease (CKD), especially due to factors like dietary restrictions and reduced physical activity.
- Severe constipation in children on peritoneal dialysis can disrupt catheter function and lead to systemic issues through gut dysbiosis.
- There's a need for effective constipation treatment in CKD, but research on its safety and effectiveness in both adults and children is limited.
Article Abstract
Functional constipation is a common problem in otherwise healthy children. Children with chronic kidney disease (CKD) and on dialysis have additional disease-related risk factors including the uremic milieu, fluid and dietary restrictions, and decreased physical activity, as well as treatment-related risk factors such as dialysis therapy and polypharmacy that contribute to and compound the problem. Constipation causes significant distress for children and their caregivers. In children on peritoneal dialysis, severe constipation can impede catheter function and ultrafiltration. Accumulating evidence points to a possible bidirectional relationship between constipation and CKD, potentially mediated by gut dysbiosis with consequent increased generation of gut-derived uremic toxins and disruption of intestinal epithelium integrity leading to translocation of noxious luminal contents into the circulation inducing systemic inflammation. Effective management of constipation is required but there is little published data on the safety and effectiveness of treatments in adults or children with CKD. In this review, we discuss the diagnosis and epidemiology of functional constipation, provide an overview of its pathophysiology, summarize the therapeutic management, and reflect on the challenges in children with CKD.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514126 | PMC |
| http://dx.doi.org/10.1007/s00467-022-05849-y | DOI Listing |
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