{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:49:15Z","timestamp":1791614955799,"version":"4.3.4"},"reference-count":109,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Gda\u0144sk","award":["02-0004\/07\/122"],"award-info":[{"award-number":["02-0004\/07\/122"]}]},{"name":"Medical University of Gda\u0144sk","award":["02-0058\/07\/262"],"award-info":[{"award-number":["02-0058\/07\/262"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chronic kidney disease (CKD) patients experience a wide range of symptoms that deteriorate their health-related quality of life (HRQoL). We aimed to estimate the prevalence and severity of lower gastrointestinal (GI) symptoms in non-dialysis CKD adult outpatients, and to summarize the relationships between these symptoms and HRQoL, laboratory test results, and clinical data. The protocol of the study was preregistered (PROSPERO CRD42021255122). We searched MEDLINE, Scopus, Web of Science, and grey literature sources from the databases\u2019 inception up until 27 November 2021. Wide citation chasing was conducted. Single proportions (prevalence of functional constipation, self-reported constipation, diarrhea, abdominal bloating, fecal incontinence, and abdominal\/rectal pain) were pooled using generalized linear mixed models. A total of 37 studies with 12,074 patients were included. We found that lower GI symptoms, especially self-reported abdominal bloating [CKD G1\u20132: 48.45% (95% CI: 43.5\u201353.4%; 2 studies); G3: 46.95% (95% CI: 45.0\u201348.9%; 2 studies), G4\u20135: 36.1% (95% CI: 25.4\u201348.5%; 8 studies)] and constipation [CKD G1\u20132: 31.8% (95% CI: 13.9\u201354.9%); G3: 29.8% (95% CI: 21.2\u201340.1%; 4 studies); G4\u20135: 38.8% (95% CI: 30.9\u201347.4%); 22 studies)], were common in non-dialysis CKD patients. The severity of the symptoms was limited. Self-reported constipation was most consistently associated with worse HRQoL, whereas hard stool consistency was associated with higher uremic toxins levels. To conclude, since lower GI symptoms are common in CKD, using symptom questionnaires that do not take them into account cannot provide full insight into the patient\u2019s experience. Further studies are needed to cover identified knowledge gaps, including the exploration of the pathophysiology of GI symptoms in CKD with multi-omics data.<\/jats:p>","DOI":"10.3390\/jcm11216363","type":"journal-article","created":{"date-parts":[[2022,10,30]],"date-time":"2022-10-30T07:26:50Z","timestamp":1667114810000},"page":"6363","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Prevalence and Severity of Lower Gastrointestinal Symptoms amongst Non-Dialysis Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9666-9627","authenticated-orcid":false,"given":"Jakub","family":"Ruszkowski","sequence":"first","affiliation":[{"name":"Department of Pathophysiology, Faculty of Medicine, Medical University of Gda\u0144sk, 80-211 Gda\u0144sk, Poland"},{"name":"Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Majkutewicz","sequence":"additional","affiliation":[{"name":"Student Scientific Circle, Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3284-0149","authenticated-orcid":false,"given":"Zbigniew","family":"Heleniak","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek M.","family":"Witkowski","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Faculty of Medicine, Medical University of Gda\u0144sk, 80-211 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-8063","authenticated-orcid":false,"given":"Alicja","family":"D\u0119bska-\u015alizie\u0144","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, Regional, and National Burden of Chronic Kidney Disease, 1990\u20132017: A Systematic Analysis for the Global Burden of Disease Study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1038\/nrneph.2017.52","article-title":"The Systemic Nature of CKD","volume":"13","author":"Zoccali","year":"2017","journal-title":"Nat. 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