In order to clarify the efficacy and safety of using a crystallized lactulose (CL) preparation to treat constipation in hemodialysis (HD) patients, we orally administered the CL preparation for 4 weeks to 28 HD patients, who had previously been treated with other laxatives for chronic constipation. The frequency of satisfactory spontaneous defecation in the 4th week treatment had significantly increased (p=0.03). In addition, stool consistency was significantly improved in the 1st, 3rd, and 4th week of the treatment (p<0.05, p<0.01, and p<0.01, respectively). Regarding the severity of constipation, the number of patients with grade 0 constipation significantly increased from none to 11 after 4 weeks’ treatment (p<0.001). In addition, the levels of blood urea nitrogen and creatinine were significantly decreased by CL-treatment (p<0.01 after 2 weeks’ treatment, p<0.05 after 4 weeks’ treatment, respectively). With regard to adverse reactions, no deaths occurred, and only one patient developed mild diarrhea, which disappeared after the CL treatment was discontinued. The above results demonstrated that CL is useful for treating chronic constipation in HD patients.

【Background】Intradialytic hypotension (IDH) is one of the major complications of hemodialysis (HD). IDH is associated with various factors; however, there is no information available about the occurrence of IDH after percutaneous coronary interventions (PCI). This study aimed to investigate the risk factors for IDH after PCI.【Method/Results】We investigated the cases of 83 consecutive HD patients (mean age: 70±7 years, males: 64) who underwent elective PCI. IDH was defined as a systolic blood pressure of <20 mmHg and HD discontinuation. We retrospectively assessed the risk factors for IDH. IDH occurred in 12 patients. In the IDH group, body weight was lower (52.0±3.8 vs. 62.9±1.5 kg; p=0.007), the administered contrast medium dose was higher (2.5±0.3 vs. 1.8±0.1 mL/kg; p=0.018), the left ventricular ejection fraction was lower (45.8±4.2 vs. 56.0±1.8% ; p=0.030), and E/e’ was higher (22.9±3.8 vs. 17.2±0.9 cm/sec; p=0.038) than in the no IDH group. There were no other significant differences in clinical characteristics between the two groups. In the logistic regression analysis, the amount of contrast medium administered per kg of body weight was found to be an independent predictor of IDH. 【Conclusion】The amount of contrast medium administered per kg of body weight was identified as an independent predictor of IDH, which suggests that patients that are administered larger doses of contrast medium during PCI might develop IDH.