{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:47:39Z","timestamp":1790390859702,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patient\u2010reported outcome measures (PROMs) are widely recognized as valuable predictors of clinical outcomes in peritoneal dialysis (PD). Our study aimed to explore the connections between patient\u2010reported constipation and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed constipation in patients across 22 facilities participating in the Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) from 2014 to 2017. Constipation diagnosis utilized objective assessment tools such as the Bristol stool form scale (BSFS) and a self\u2010reported questionnaire known as the constipation severity score (CSS). The BSFS is a 7\u2010level scale that visually inspects feces based on texture and morphology, while the CSS measures constipation duration and severity using a 5\u2010point Likert scale for various factors. We employed Cox proportional hazards model regression to determine the associations between constipation and clinical outcomes, including mortality, hemodialysis (HD) transfer and peritonitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 975 randomly selected PD patients from 22 facilities, 845 provided written informed consent, and 729 completed CSS questionnaire. Constipation was prevalent in the PD population (13%), particularly among older patients, those who were caregiver dependent, had diabetes and poorer nutritional status (indicated by lower time\u2010averaged serum albumin, potassium, creatinine and phosphate concentrations). Twenty\u2010seven percent of which experiencing symptoms of constipation for over a year. Notably, self\u2010reported constipation at baseline was significantly associated with a shorter time to first peritonitis and higher rates of peritonitis and death. However, no significant association was found between constipation and HD transfer after adjusting for various factors, including age, gender, PD vintage, comorbidities, shared frailty by study sites and serum albumin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patient\u2010reported constipation independently correlated with increased risks of peritonitis and all\u2010cause mortality, though no such correlation was observed with HD transfer. These findings underscore the need for further investigation to identify effective interventions for constipation in PD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.14224","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T12:28:31Z","timestamp":1691065711000},"page":"35-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Constipation and clinical outcomes in peritoneal dialysis: Results from Thailand <scp>PDOPPS<\/scp>"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1762-1535","authenticated-orcid":false,"given":"Guttiga","family":"Halue","sequence":"first","affiliation":[{"name":"Department of Medicine Phayao Hospital  Phayao Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huttaporn","family":"Tharapanich","sequence":"additional","affiliation":[{"name":"Bamrasnaradura Infectious Diseases Institute  Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3524-6292","authenticated-orcid":false,"given":"Jeerath","family":"Phannajit","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-8934","authenticated-orcid":false,"given":"Talerngsak","family":"Kanjanabuch","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athiphat","family":"Banjongjit","sequence":"additional","affiliation":[{"name":"Nephrology Unit, Department of Medicine Vichaiyut Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2206-1539","authenticated-orcid":false,"given":"Pichet","family":"Lorvinitnun","sequence":"additional","affiliation":[{"name":"Department of Medicine Sunpasitthiprasong Hospital  Ubon Ratchathani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2291-1580","authenticated-orcid":false,"given":"Suchai","family":"Sritippayawan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Siriraj Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wichai","family":"Sopassathit","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Pranangklao Hospital  Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4949-7324","authenticated-orcid":false,"given":"Ussanee","family":"Poonvivatchaikarn","sequence":"additional","affiliation":[{"name":"Nephrology Clinic Department of Internal Medicine, Nakhon Pathom Hospital  Nakhon Pathom Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somphon","family":"Buranaosot","sequence":"additional","affiliation":[{"name":"Bangkok Metropolitan Administration General Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanida","family":"Somboonsilp","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine, Chaoprayayomraj Hospital  Suphanburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pimpong","family":"Wongtrakul","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine, Chaoprayayomraj Hospital  Suphanburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7385-2675","authenticated-orcid":false,"given":"Chanchana","family":"Boonyakrai","sequence":"additional","affiliation":[{"name":"Department of Medicine King Taksin Memorial Hospital, Bangkok Metropolitan Administration  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6903-5039","authenticated-orcid":false,"given":"Surapong","family":"Narenpitak","sequence":"additional","affiliation":[{"name":"Renal Unit, Department of Internal Medicine Udonthani Hospital  Udon Thani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3843-3894","authenticated-orcid":false,"given":"Sajja","family":"Tatiyanupanwong","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Chaiyaphum Hospital  Chaiyaphum Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wadsamon","family":"Saikong","sequence":"additional","affiliation":[{"name":"CAPD Clinic Department of Internal Medicine, Mukdahan Hospital  Mukdahan Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriphrae","family":"Uppamai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Sukhothai Hospital  Sukhothai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setthapon","family":"Panyatong","sequence":"additional","affiliation":[{"name":"Kidney Center, Department of Internal Medicine Nakornping Hospital  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5061-4359","authenticated-orcid":false,"given":"Rutchanee","family":"Chieochanthanakij","sequence":"additional","affiliation":[{"name":"Dialysis Unit, Department of Medicine Sawanpracharak Hospital  Nakhon Sawan Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9633-2880","authenticated-orcid":false,"given":"Niwat","family":"Lounseng","sequence":"additional","affiliation":[{"name":"Department of Medicine Trang Hospital  Trang Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8134-104X","authenticated-orcid":false,"given":"Angsuwarin","family":"Wongpiang","sequence":"additional","affiliation":[{"name":"CAPD Unit Medical Service Department, Pong Hospital  Phayao Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8590-4188","authenticated-orcid":false,"given":"Worapot","family":"Treamtrakanpon","sequence":"additional","affiliation":[{"name":"Department of Medicine Chaophaya Abhaibhubejhr Hospital  Prachin Buri Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peerapach","family":"Rattanasoonton","sequence":"additional","affiliation":[{"name":"Department of Medicine Trat Hospital  Trat Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9504-6591","authenticated-orcid":false,"given":"Narumon","family":"Lukrat","sequence":"additional","affiliation":[{"name":"Medical Staff Organization KhueangNai Hospital  Ubon Ratchatani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7931-4069","authenticated-orcid":false,"given":"Phichit","family":"Songviriyavithaya","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine Amnatcharoen Hospital  Amnatcharoen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-0496","authenticated-orcid":false,"given":"Uraiwan","family":"Parinyasiri","sequence":"additional","affiliation":[{"name":"Kidney diseases clinic, Department of internal medicines Songkhla Hospital  Songkhla Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyarat","family":"Rojsanga","sequence":"additional","affiliation":[{"name":"Renal Unit, Department of Internal Medicine Udonthani Hospital  Udon Thani Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patnarin","family":"Kanjanabuch","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Faculty of Dentistry Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongpratch","family":"Puapatanakul","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3818-9761","authenticated-orcid":false,"given":"Krit","family":"Pongpirul","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine and Center of Excellence in Preventive &amp; Integrative Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"School of Global Health, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"},{"name":"Department of International Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Faculty of Health and Life Sciences University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-7849","authenticated-orcid":false,"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Kidney and Transplant Services, Division of Medicine Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Australasian Kidney Trials Network Centre for Health Services Research, University of Queensland  Brisbane Queensland Australia"},{"name":"Centre for Kidney Disease Research Translational Research Institute  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0008-7623","authenticated-orcid":false,"given":"Jeffrey","family":"Perl","sequence":"additional","affiliation":[{"name":"St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0255-6710","authenticated-orcid":false,"given":"Roberto","family":"Pecoits\u2010Filho","sequence":"additional","affiliation":[{"name":"Pontifical Catholic University, of Parana  Curitiba Brazil"},{"name":"Arbor Research Collaborative for Health  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6041-7989","authenticated-orcid":false,"given":"Vuddhidej","family":"Ophascharoensuk","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-9306","authenticated-orcid":false,"given":"Kriang","family":"Tungsanga","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Thailand PDOPPS Steering Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2010.12.010"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13243"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.03.026"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.01.007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2018.12.021"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.11.002"},{"key":"e_1_2_9_8_1","first-page":"8","article-title":"Chronic kidney disease, gut Dysbiosis, and constipation: a burdensome triplet","volume":"12","author":"Ikee R","year":"2020","journal-title":"Microorganisms"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12301"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0896860819895364"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-019-0246-3"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5414\/CN107249"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2014.00288"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0896860821993950"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529709011203"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s101510100019"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2018.00169"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02056950"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/10.1_Part_1.20"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01590.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2018.00094"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.15.1701"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/08968608221080586"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2014.00341"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-016-0724-2"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072608"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/089686089601600419"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13859"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.10.022"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0588-4"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000132"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202203"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2018.00232"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T18:58:32Z","timestamp":1692212312000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.14224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":34,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/nep.14224"],"URL":"https:\/\/doi.org\/10.1111\/nep.14224","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]},"assertion":[{"value":"2023-07-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}