Lactulose efficacy in reduction of nitrogen products, blood potassium and fluid overload in patients with end-stage renal failure

Abstract

Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stage<br />disease. Patients with chronic kidney disease face with uremic toxins and hyperkalemia. Also fluid overload<br />in CKD patients is associated with rapid decline in kidney function. Lactulose is a hyper osmotic agent and<br />as a prebiotic plays an important role in regulating serum urea and potassium levels and have some effects<br />on fluid overload. The aim of this study was to evaluate effect of lactulose on serum levels of biochemical<br />products in patients with CKD. In this interventional study 17 patients with end stage of CKD (76.47 % men;<br />mean age 65.88 ± 13.4) were evaluated. All patients received lactulose, 10 ml, 3 times per day for 3 months.<br />Blood samples from all participants were collected before and at the end of intervention to examine changes<br />in biochemical parameters, including potassium, urea, creatinine and uric acid.<br />Lactulose significantly decreased urea levels (p=0.001), blood potassium (0.001) and fluid overload(with due<br />attention to patient's weight p=0.001) in patients with end-stage renal failure. The decrease in serum creatinin<br />anduric acidwere not significant. Lactulose administration in CKD patients could decrease levels of various<br />deleterious elements especially urea and blood potassium, and its daily use can be recommended in these<br />patients.