TY - JOUR
T1 - Constipation and diabetic kidney disease
T2 - The Fukuoka Diabetes Registry
AU - Ohkuma, Toshiaki
AU - Iwase, Masanori
AU - Fujii, Hiroki
AU - Ide, Hitoshi
AU - Komorita, Yuji
AU - Yoshinari, Masahito
AU - Oku, Yutaro
AU - Higashi, Taiki
AU - Oshiro, Ayaka
AU - Nakamura, Udai
AU - Kitazono, Takanari
N1 - Funding Information:
The authors thank Drs. Toshiharu Ninomiya, Dongchon Kang, Shuzo Kumagai, Yoichiro Hirakawa, Shinako Kaizu-Ogata, Akiko Sumi, Tamaki Jodai-Kitamura, Ai Murao-Kimura (Kyushu University), Nobutaka Tsutsu (deceased), Nobuhiro Sasaki (Fukuoka Red Cross Hospital), Kiyohide Nunoi, Yuichi Sato, Yuji Uchizono, Kaori Itoh (St. Mary’s Hospital), Hirofumi Imoto (Steel Memorial Yawata Hospital), Daisuke Gotoh (Kyushu Central Hospital), Sakae Nohara, Ayako Tsutsumi (Fukuoka Higashi Medical Center), Yasuhiro Idewaki (Hakujyuji Hospital), Masae Minami (Clinic Minami Masae), Miya Wada (Wada Miya Naika Clinic), Yoshifumi Yokomizo (Yokomizo Naika Clinic), Masanori Kikuchi, Yohei Kikuchi (Kikuchi Naika Clinic), Riku Nomiyama (Suzuki Naika Clinic), Shin Nakamura (Nakamura Naika Clinic), Kenji Tashiro (Oshima Eye Hospital), Mototaka Yoshinari (Yoshinari Naika Clinic), Kojiro Ichikawa (Fukutsu Naika Clinic), and Yutaka Kiyohara and Teruo Omae (Hisayama Research Institute For Lifestyle Diseases). The authors also thank the clinical research coordinators, Chiho Ohba (Hisayama Research Institute For Lifestyle Diseases) and Yoko Nishioka (Kyushu University), and those in the administration office, Tomoko Matake (Hisayama Research Institute For Lifestyle Diseases) and Junko Ishimatsu (Kyushu University). We thank Richard Robins, PhD, from Edanz Group for editing a draft of this manuscript.
Funding Information:
This work was supported in part by The Japan Society for the Promotion of Science (KAKENHI), from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers 19K24229 and 21K11700 to T.O., 23249037 and 23659353 to M.I., 16K00861 to H.F., and 20K19663 to Y.K.), a Junior Scientist Development Grant from the Japan Diabetes Society (to T.O. and Y.K.), Grants for young researchers from Japan Association for Diabetes Education and Care (to T.O.), a grant from the Japan Diabetes Foundation (to T.O.), and a Japan Heart Foundation and Astellas/Pfizer Grant for Research on Atherosclerosis Update (to T.O.).
Publisher Copyright:
© 2021, Japanese Society of Nephrology.
PY - 2021/11
Y1 - 2021/11
N2 - Background: Constipation was shown to be associated with higher risk of end-stage kidney disease or incident chronic kidney disease, although evidence in diabetic patients is lacking. The objective of the present study was to examine the association between constipation and diabetic kidney disease (DKD). Methods: In total, 4826 Japanese outpatients with type 2 diabetes were classified according to presence or absence of constipation (defecation frequency < 3 times/week and/or taking laxative medication). DKD was defined as presence of decreased estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m2), and/or albuminuria (urinary albumin-to-creatinine ratio ≥ 30 mg/g). Odds ratios for the presence of DKD were computed by a logistic regression model. Results: Compared with participants without constipation, the age- and sex-adjusted odds ratio for presence of DKD was 1.58 (95% confidence interval 1.38–1.82) for those with constipation. This association persisted following adjustment for potential confounding factors. Decreased defecation frequency and laxative use were also significantly associated with higher prevalence of DKD. Overall, these findings were identical even when decreased eGFR and albuminuria were separately analyzed. Conclusions: Constipation was associated with higher likelihood of DKD in patients with diabetes, suggesting the importance of clinical assessment of constipation to identify patients at high risk of progression of kidney disease.
AB - Background: Constipation was shown to be associated with higher risk of end-stage kidney disease or incident chronic kidney disease, although evidence in diabetic patients is lacking. The objective of the present study was to examine the association between constipation and diabetic kidney disease (DKD). Methods: In total, 4826 Japanese outpatients with type 2 diabetes were classified according to presence or absence of constipation (defecation frequency < 3 times/week and/or taking laxative medication). DKD was defined as presence of decreased estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m2), and/or albuminuria (urinary albumin-to-creatinine ratio ≥ 30 mg/g). Odds ratios for the presence of DKD were computed by a logistic regression model. Results: Compared with participants without constipation, the age- and sex-adjusted odds ratio for presence of DKD was 1.58 (95% confidence interval 1.38–1.82) for those with constipation. This association persisted following adjustment for potential confounding factors. Decreased defecation frequency and laxative use were also significantly associated with higher prevalence of DKD. Overall, these findings were identical even when decreased eGFR and albuminuria were separately analyzed. Conclusions: Constipation was associated with higher likelihood of DKD in patients with diabetes, suggesting the importance of clinical assessment of constipation to identify patients at high risk of progression of kidney disease.
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U2 - 10.1007/s10157-021-02105-9
DO - 10.1007/s10157-021-02105-9
M3 - Article
C2 - 34173920
AN - SCOPUS:85108779229
SN - 1342-1751
VL - 25
SP - 1247
EP - 1254
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
IS - 11
ER -
