Gastrointestinal symptom burden and dietary intake in patients with chronic kidney disease

J Ren Care. 2021 Dec;47(4):234-241. doi: 10.1111/jorc.12373. Epub 2021 Apr 30.

Abstract

Background: Gastrointestinal (GI) symptoms can present a significant burden to patients with chronic kidney disease (CKD) but the reported prevalence is inconsistent.

Objective: To examine the GI burden and dietary intake in patients with CKD with or without dialysis.

Methods: This was a cross-sectional study of 216 adults, recruited from outpatient and dialysis clinics, with CKD stage 4 or 5 not receiving dialysis (CKD-ND), or receiving haemodialysis (HD) or peritoneal dialysis (PD). Three questionnaires were administered: the Bristol Stool Form Scale (BSFS); a modified Gastrointestinal Symptom Rating Scale and a short Food Frequency Questionnaire. Outcomes were stool frequency and consistency, GI symptoms and dietary intake.

Results: Data were collected from 216 patients (mean age, 63 years [95% CI: 61, 65]; 63% males; CKD-ND: n = 134; HD: n = 67; PD: n = 15). Mean stool frequency for all groups was one bowel action per day (p = .45) and consistency was normal (BSFS type 4, p = .95). Overall GI symptom burden was low but several symptoms occurred at least "most of the time" including "tiredness/lethargy" (54% of participants), "reduced appetite" (29%), "early satiety" (25%) and "change in taste" (15%). Low intakes of fresh fruit, vegetables, whole-grains and legumes were found. No associations were observed between diet and GI symptoms.

Conclusion: The overall GI symptom burden was low, but >15% of participants reported several symptoms as occurring most to all of the time. Low intakes of fresh fruit, vegetables, whole-grains and legumes were observed in all CKD patients.

Keywords: chronic kidney disease; dialysis; diarrhoea; diet; gastrointestinal symptoms.

MeSH terms

  • Cross-Sectional Studies
  • Eating
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peritoneal Dialysis*
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / complications