Gutted: constipation in children with chronic kidney disease and on dialysis.

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-relate...

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Publicado en:Pediatric Nephrology Vol. 38; no. 11; pp. 3581 - 3597
Autores principales: Wan, Mandy, King, Lillian, Baugh, Natasha, Arslan, Zainab, Snauwaert, Evelien, Paglialonga, Fabio, Shroff, Rukshana
Formato: exam questions pictorial review tables/charts Journal Article
Publicado: Springer Nature Nov2023
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Gutted: constipation in children with chronic kidney disease and on dialysis.
      aug:
        au:
          Wan, Mandy
          King, Lillian
          Baugh, Natasha
          Arslan, Zainab
          Snauwaert, Evelien
          Paglialonga, Fabio
          Shroff, Rukshana
        affil: Evelina Pharmacy Department, Evelina London Children's Hospital, NHS Foundation Trust, Guy's and St ThomasWestminster Bridge Road, SE1 7EH, London, UK
      sug:
        subj:
          Dialysis Patients In Infancy and Childhood
          Renal Insufficiency, Chronic Therapy
          Gut Microbiota Adverse Effects
          Constipation Epidemiology
          Child
          Pathologic Processes Risk Factors
          Constipation Therapy
          Cathartics Therapeutic Use
          Child: 6-12 years
      ab: 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.
      pubtype: Academic Journal
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    language: English
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