Kidney Week

Abstract: TH-PO1065

Prevalence and Risk of Constipation Across the Spectrum of CKD: A Large Nationwide Japanese Health Checkup Cohort Study

Session Information

• CKD: Epidemiology, Risk Factors, and Other Conditions
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Hirano, Keita, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Kyoto Prefecture, Japan

Keita Hirano, MD, PhD

• Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Keiichi Sumida, MD, PhD, MPH, FASN

• Fukuma, Shingo, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Kyoto Prefecture, Japan

Shingo Fukuma, MD, PhD

Background

Constipation is one of the most common gastrointestinal disorders in patients with CKD. However, the prevalence and risk of constipation have not been comprehensively studied across stages of CKD.

Methods

Using nationwide annual health checkup and insurance claims records from 2015-2023 in Japan, we identified 1,195,166 health checkup participants aged 20-75 years with eGFR data available. We assessed the prevalence of constipation, defined based on diagnostic codes or laxative use, overall and across eGFR categories (≥60, 45-59, 30-44, 15-29, <15 ml/min/1.73m²), and cross-sectionally examined the association between constipation and eGFR levels, using multivariable logistic regression models with adjustment for potential confounders.

Results

Overall, participants were 49±11 years old; 72% were male; and 11% had diabetes. Among the 1,195,166 participants, 117,017 (9.8%) had constipation. The prevalence of constipation was higher in the lower eGFR categories, with 9.4%, 13.4%, 20.4%, 28.3%, and 50.7% in eGFR ≥60, 45-59, 30-44, 15-29, and <15 ml/min/1.73m², respectively (Figure). After multivariable adjustment, constipation was significantly associated with eGFR levels, with an incrementally higher risk seen in lower levels of eGFR (adjusted ORs [95% CI], 1.22 [1.19-1.24], 1.57 [1.47-1.68], 2.26 [1.96-2.60], and 3.74 [3.31-4.23] for eGFR 45-59, 30-44, 15-29, and <15 [vs. ≥60] ml/min/1.73m², respectively; Table).

Conclusion

Constipation was more prevalent in advanced stages of CKD and independently associated with a higher risk of moderate to advanced CKD, with the highest risk seen in the most advanced stage. Our findings suggest a potential biological link between constipation and CKD and a need for careful monitoring of constipation symptoms in individuals with CKD, particularly in those with low eGFR.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025t7fzdsva