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Войти в исследования Clinical and experimental nephrology · 2026
The coexistence of constipation and diarrhea is associated with the development of chronic kidney disease: a 10-year cohort study.
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Mori Kazuma, Tanaka Marenao, Akiyama Yukinori, Abe Koki, Nishizawa Keitaro, Aida Hiroki, Kawano Yutaka, Okagawa Yutaka, Matsumori Rie, Nakata Kei, Hosaka Itaru, Kouzu Hidemichi, Hanawa Nagisa, Sato Tatsuya, Furuhashi Masato
Аннотация
BACKGROUND: The gut-kidney axis is a potential mechanism underlying kidney dysfunction. However, the relationship between chronic kidney disease (CKD) and bowel habit subtypes, especially the coexistence of constipation and diarrhea, remains unknown.
METHODS: We investigated the association of bowel habit subtypes including the no-constipation/diarrhea, constipation-only, diarrhea-only and coexisting constipation/diarrhea groups with new onset of CKD during a 10-year follow-up period in 14,876 Japanese adults (men/women: 9,620/5,256, mean age: 47 years) who underwent annual health examinations.
RESULTS: During a median follow-up of 7.0 years, 2,281 participants (men/women: 1,571/710) developed CKD. Multivariable Cox proportional hazards models analysis after adjustment for age, sex and several confounders showed that hazard ratio (HR) for the development of CKD was significantly higher in the coexisting constipation/diarrhea group (HR [95% confidence interval]: 1.24 [1.06-1.46], p = 0.008), but not the constipation-only group or diarrhea-only group, than in the no-constipation/diarrhea group. Sex-stratified analyses showed that the adjusted HR in women, but not in men, was significantly higher in the constipation-only and coexisting constipation/diarrhea groups than in the no-constipation/diarrhea group, though the interaction by sex was not statistically significant (p = 0.118). In the mutually adjusted analysis using frequency of constipation/diarrhea, frequent constipation was independently associated with the development of CKD. The addition of bowel habit subtypes into traditional risk factors for CKD significantly improved the discriminatory capacity.
CONCLUSIONS: The coexistence of constipation and diarrhea is independently associated with an increased risk for the development of CKD. The bowel habit subtype provides clinically relevant information regarding future risk for CKD.
METHODS: We investigated the association of bowel habit subtypes including the no-constipation/diarrhea, constipation-only, diarrhea-only and coexisting constipation/diarrhea groups with new onset of CKD during a 10-year follow-up period in 14,876 Japanese adults (men/women: 9,620/5,256, mean age: 47 years) who underwent annual health examinations.
RESULTS: During a median follow-up of 7.0 years, 2,281 participants (men/women: 1,571/710) developed CKD. Multivariable Cox proportional hazards models analysis after adjustment for age, sex and several confounders showed that hazard ratio (HR) for the development of CKD was significantly higher in the coexisting constipation/diarrhea group (HR [95% confidence interval]: 1.24 [1.06-1.46], p = 0.008), but not the constipation-only group or diarrhea-only group, than in the no-constipation/diarrhea group. Sex-stratified analyses showed that the adjusted HR in women, but not in men, was significantly higher in the constipation-only and coexisting constipation/diarrhea groups than in the no-constipation/diarrhea group, though the interaction by sex was not statistically significant (p = 0.118). In the mutually adjusted analysis using frequency of constipation/diarrhea, frequent constipation was independently associated with the development of CKD. The addition of bowel habit subtypes into traditional risk factors for CKD significantly improved the discriminatory capacity.
CONCLUSIONS: The coexistence of constipation and diarrhea is independently associated with an increased risk for the development of CKD. The bowel habit subtype provides clinically relevant information regarding future risk for CKD.