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)

BMC Nephrology

Anh Kieu¹  Jonathan C. Craig²  Tess E. Cooper³  Nicole Scholes-Robertson³  Wai H. Lim⁴  Martin Howell⁵  Amy Dalton⁵  Armando Teixeira-Pinto⁵  Allison Tong⁵  Rabia Khalid⁵  Germaine Wong⁶  Sumedh Jayanti⁷  Michael J. Bourke⁸ 

[1] Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia;Cochrane Kidney and Transplant, The Children’s Hospital at Westmead, Westmead, Australia;College of Medicine and Public Health, Flinders University, Adelaide, Australia;Cochrane Kidney and Transplant, The Children’s Hospital at Westmead, Westmead, Australia;Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, 2006, Camperdown, NSW, Australia;Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia;Sir Charles Gairdner Hospital, Nedlands, Australia;School of Medicine, University of Western Australia, Perth, Australia;Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, 2006, Camperdown, NSW, Australia;Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia;Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, 2006, Camperdown, NSW, Australia;Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia;Westmead Hospital, Westmead, Australia;Westmead Hospital, Westmead, Australia;Westmead Hospital, Westmead, Australia;School of Medicine, The University of Sydney, Sydney, Australia;

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

DOI  :  10.1186/s12882-021-02600-x

来源: Springer

【 摘 要 】

BackgroundGastro-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.MethodsThe 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.DiscussionThis 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.Trial registrationThis study is registered on the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000548831. This study has been approved by the Western Sydney Local Health District Human Research Ethics Committee of New South Wales Health (HREC ETH03007). This study is supported by a National Health and Medical Research Council (NHMRC) Australia Investigator Grant (APP1195414), and an NHMRC Australia Postgraduate Scholarship (APP2005244).

【 授权许可】

CC BY