The CKD bowel health study: understanding the bowel health and gastrointestinal symptom management in patients with chronic kidney disease: a mixed-methods observational longitudinal study (protocol)

Tess E. Cooper, Amy Dalton, Anh Kieu, Martin Howell, Sumedh Jayanti, Rabia Khalid, Wai H. Lim, Nicole Scholes-Robertson, Jonathan C. Craig, Armando Teixeira-Pinto, Michael J. Bourke, Allison Tong, Germaine Wong

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Gastro-intestinal (GI) intolerance is a frequently reported outcome in patients with kidney failure receiving maintenance dialysis and those who have received kidney transplants. Symptoms of GI intolerance (diarrhoea, constipation, bloating, abdominal pain, heart burn, and reflux) are associated with significant reduction in quality of life, morbidity, and increased used of healthcare resources. Having chronic kidney disease (CKD), together with related changes in diet and medication, may alter the gut microbiota and the microbial-derived uraemic metabolites that accumulate in kidney failure, and contribute to various complications including chronic diarrhoea, opportunistic infections, and drug-related colitis. Despite the high disease burden among patients with kidney replacement therapies, GI symptoms are often under-recognised and, consequently limited resources and strategies are devoted to the management of gastrointestinal complications in patients with CKD. Methods: The CKD Bowel Health Study is a multi-centre mixed-methods observational longitudinal study to better understand the bowel health and GI symptom management in patients with CKD. The program comprises of a longitudinal study that will assess the burden and risk factors of GI intolerance in patients treated with maintenance dialysis; a semi-structured interview study that will describe experiences of GI intolerance (including symptoms, treatment, self-management) in transplant candidates and recipients; and a discrete choice experience to elicit patient preferences regarding their experiences and perspectives of various intervention strategies for the management of GI symptoms after kidney transplantation. Discussion: This proposed program of work aims to define the burden the GI intolerance in patients with kidney failure and generate evidence on the patients’ experiences of GI intolerance and their perspectives on their clinical and own management strategies of these symptoms, ensuring a patient-centred approach to guide clinical decision making and to inform the best study design for intervention trials.

Original languageEnglish
Article number388
Number of pages8
JournalBMC NEPHROLOGY
Volume22
Issue number1
DOIs
Publication statusPublished - 21 Nov 2021

Keywords

  • Chronic kidney disease
  • Dialysis
  • Discrete choice experiment
  • Gastrointestinal symptoms
  • Gut microbiome
  • Gut microbiota
  • Kidney transplant
  • Observational longitudinal study
  • Qualitative interview
  • Uremic toxins

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