Abstract
Objective:The aim of this study was to investigate the effects of elobixibat on constipation and lipid metabolism; and determine the factors associated with the effect of elobixibat on constipation in patients with moderate to end-stage chronic kidney disease (CKD).Methods:Stool frequency and serum lipid parameters were retrospectively analyzed before and after 4 weeks of elobixibat administration in 42 patients (CKD stage G3, 6; stage G4, 9; stage G5, 9; stage G5D, 18). Relationships between the change in stool frequency after initiation of elobixibat and various clinical parameters were analyzed by using linear regression analysis.Results:Elobixibat increased stool frequency from 0.5 ± 0.4 per day to 1.1 ± 0.6 per day (p < 0.001) regardless of whether patients were undergoing dialysis, on concomitant laxatives, or were administered elobixibat before or after breakfast. Elobixibat reduced low-density lipoprotein cholesterol concentration (from 90.9 ± 37.2 mg/dL to 77.5 ± 34.8 mg/dL, p < 0.05) and increased high-density lipoprotein cholesterol concentration (from 44.9 ± 14.3 mg/dL to 57.0 ± 25.8 mg/dL, p < 0.05), but did not change triglyceride concentration. Adverse effects were observed in two patients (nausea and diarrhea). Only phosphate concentration was correlated with the change in stool frequency after initiation of elobixibat (standard coefficient = 0.321, p = 0.043).Conclusions:Elobixibat improved constipation and lipid metabolism in patients with moderate to end-stage CKD, without serious adverse events.
Highlights
Chronic constipation is a common complication in patients with chronic kidney disease (CKD) and is associated with progression of CKD, development of cardiovascular disease, poor quality of life, and frailty and sarcopenia [1–4]
The aim of this study was to investigate the effects of elobixibat on constipation and lipid metabolism; and determine the factors associated with the effect of elobixibat on constipation in patients with moderate to end-stage chronic kidney disease (CKD)
Phosphate concentration was correlated with the change in stool frequency after initiation of elobixibat
Summary
Chronic constipation is a common complication in patients with chronic kidney disease (CKD) and is associated with progression of CKD, development of cardiovascular disease, poor quality of life, and frailty and sarcopenia [1–4]. Optimal treatment of chronic constipation is important for preserving renal function, preventing development of cardiovascular events, improving quality of life, and mitigating progression of frailty and sarcopenia. Elobixibat is a novel laxative that inhibits bile acid transporters expressed in epithelial cells of the terminal ileum and increases the amount of bile acid flowing into the colon lumen [8]. It increases water secretion into the large intestine lumen and promotes intestinal motility. Few studies have investigated the effects of elobixibat on constipation and lipid metabolism in patients with renal impairment. In the present study, we investigated the factors associated with the effect of elobixibat on constipation, as well as the effects of elobixibat on constipation and lipid metabolism in patients with moderate to endstage CKD
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