Abstract: PUB249
Management of Gastrointestinal Symptoms in Patients with Advanced CKD: A Systematic Review Protocol
Session Information
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Gordon, Freddy, University of Dundee, Dundee, Scotland, United Kingdom
- Traill, Philippa Kirsten, University of Dundee, Dundee, Scotland, United Kingdom
- McCabe, Callum, University of Dundee, Dundee, Scotland, United Kingdom
- Lawson, Jeremiah, University of Dundee, Dundee, Scotland, United Kingdom
- Lim, Jo Vi, NHS Tayside, Dundee, Scotland, United Kingdom
- Yung, Joey, NHS Tayside, Dundee, Scotland, United Kingdom
- Saji Kadapurath, Jeffin, University of Dundee, Dundee, Scotland, United Kingdom
- March, Daniel Scott, University of Leicester, Leicester, England, United Kingdom
- Smith, Ellesha A., University of Leicester, Leicester, England, United Kingdom
- Burton, James, University of Leicester, Leicester, England, United Kingdom
- Evans, David, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, England, United Kingdom
Background
Gastrointestinal (GI) symptoms affect up to 80% of patients with advanced CKD, impairing treatment tolerance and quality of life. Symptom burden in end-stage kidney disease is comparable to advanced malignancy yet remains underrecognised and undertreated. High-quality evidence for managing GI symptoms is limited, and guidelines often exclude this population. Evidence is fragmented across CKD populations, symptoms, and interventions, limiting translation into practice. To our knowledge, this review will be the first comprehensive evidence synthesis in this population, informing clinical decision-making, guideline development and future research.
Methods
Objectives
Primary: Evaluate pharmacological and non-pharmacological interventions for GI symptoms in advanced CKD
Secondary: Assess adverse events, quality of life, life participation, all-cause and cardiovascular mortality
Methods
Adults and children with CKD stage G3a-5, kidney transplant, renal replacement therapy or conservative kidney management with ≥1 GI symptom included. Interventions compared with usual care, placebo or sham. RCTs, non-randomised controlled trials and observational studies eligible for inclusion. MEDLINE, Embase, CINAHL, CENTRAL, PubMed, Web of Science, ClinicalTrials.gov and conference proceedings searched. Risk of bias assessed independently by 2 reviewers using NIH tools. RCT data pooled by meta-analysis; non-randomised studies analysed separately; narrative synthesis where pooling not feasible. Evidence certainty assessed using GRADE.
Results
Database searching is complete; full-text screening ongoing. Study results will be available prior to ASN Kidney Week 2026.
Conclusion
This review will provide the first comprehensive synthesis of pharmacological and non-pharmacological management of GI symptoms across advanced CKD, informing clinical practice, guideline development and future research.
Acknowledgment
Affiliation: UK Kidney Association (UKKA)
Peer review: Protocol developed in collaboration with the UKKA Symptom Management in End-Stage Kidney Disease GI Symptom Special Interest Group. Independent review performed by the University of Dundee Library Team
Funding: This study receives no external funding. Abstract submission funding is supported by the UKKA