P1479HIGHER FREQUENCY OF FRUIT INTAKE IS ASSOCIATED WITH LOWER RISK OF CONSTIPATION IN HEMODIALYSIS PATIENTS - A MULTI-CENTRE STUDY

Abstract

Abstract Background and Aims Constipation is a multifactorial gastrointestinal disorder commonly found in hemodialysis (HD) patients. In this multi-centre cross-sectional study, we aimed to evaluate the prevalence and factors associated with constipation, including the frequency of dietary fiber sources intake. Method Prevalent HD patients from four dialysis clinics in Southern Brazil were invited to participate (at least 80% of eligible patients from each clinic). Patients were interviewed by the researchers and answered a questionnaire that comprised ROMA III criteria questions to assess constipation status, use of medications and life habits. A food frequency questionnaire (FFQ) with the main dietary fiber sources (fruits, vegetables, legumes, whole grains cereals and seeds) was applied with seven frequency possibilities (from never to more than twice a day). To estimate the weekly frequency of intake, answers were transformed into a score. Every score point corresponded to one time per week (ex.: score 7 = seven times per week). Demographical and laboratory data were obtained from medical records. Univariate analysis was used to compare participants according to constipation status and variables with P<0.20 were included in the regression analysis model. Results 305 HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19 – 82) months). Ninety-three participants had constipation (30.5%). Median (interquartile) FFQ scores were: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole-grain: 0 (0-1) and seeds: 0 (0-0). In univariate analysis, participants with constipation were significantly older (55.1 ± 14.8 versus 51.0 ± 14.5 years old; P=0.02), had lower literacy (5 (5-11) versus 8 (4-13) years at school; P=0.007), higher prevalence of diabetes (41 versus 23%; P=0.002) and lower total beverage intake (15 (12-20) versus 17 (12-24) ml/kg/day; P=0.04). The logistic regression analysis model also included body mass index; wheelchair need; sedentarism; fruits score and seeds score (all with P<0.20 in the univariate analysis).The independent predictors of constipation were diabetes (OR=1.96 (95%IC 1.07-3.6);P=0.03) and fruits intake score (OR=0.95 (95%IC 0.91-0.99);P=0.04) Conclusion Almost one-third of participants had constipation, and usual intake of fiber food sources was low. The independent determinants of constipation were diabetes and a lower frequency of fruit intake. Nutritional counselling to increase fiber intake sources can potentially decrease the prevalence of constipation of this population.