Contact Laxative Use and the Risk of Arteriovenous Fistula Maturation Failure in Patients Undergoing Hemodialysis: A Multi-Center Cohort Study

Trung Hoang Anh, Phung-Anh Nguyen, Anh Duong, I-Jen Chiu, Chu-Lin Chou, Yu-Chen Ko, Tzu-Hao Chang, Chih-Wei Huang, Mai-Szu Wu, Chia-Te Liao and Yung-Ho Hsu
Additional contact information
Trung Hoang Anh: International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
Phung-Anh Nguyen: Clinical Data Center, Office of Data Science, Taipei Medical University, Taipei 110, Taiwan
Anh Duong: Macquarie Business School, Macquarie University, Sydney, NSW 2109, Australia
I-Jen Chiu: Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan
Chu-Lin Chou: Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
Yu-Chen Ko: Division of Cardiovascular Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan
Tzu-Hao Chang: Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
Chih-Wei Huang: Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
Mai-Szu Wu: Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan
Chia-Te Liao: Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan
Yung-Ho Hsu: Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan

IJERPH, 2022, vol. 19, issue 11, 1-11

Abstract: Laxatives are commonly prescribed for constipation management; however, they are recognized as an independent factor associated with cardiovascular diseases. Arteriovenous fistula (AVF) is the closest to the ideal model of hemodialysis (HD) vascular access and part of the cardiovascular system. Our study aims to explore the association of contact laxative use with AVF maturation outcomes in patients undergoing HD. We conducted a multi-center cohort study of 480 contact laxative users and 472 non-users who had undergone initial AVF creation. All patients were followed until the outcomes of AVF maturation were confirmed. Multivariable logistic regression models were performed to evaluate the risk of AVF maturation failure imposed by laxatives. Here, we found that patients who used contact laxatives were significantly associated with an increased risk of AVF maturation failure compared to non-users (adjusted odds ratio, 1.64; p = 0.003). Notably, the risk of AVF maturation failure increased when increasing their average daily doses and cumulative treatment days. In conclusion, our study found a significant dose- and duration-dependent relationship between contact laxative use and an increased risk of AVF maturation failure. Thus, laxatives should be prescribed with caution in this population. Further studies are needed to validate these observations and investigate the potential mechanisms.

Keywords: contact laxatives; arteriovenous fistula; maturation failure; end-stage kidney disease; hemodialysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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