Constipation is a highly prevalent
gastrointestinal disorder in patients with
chronic kidney disease (CKD). However, our understanding of its epidemiology and management in CKD is limited. We aimed to explore real-world data on
constipation and
laxative use in patients with CKD in a nationwide population-based cohort from the Korean Health Insurance Review and Assessment-National Patient Sample database. This study analyzed retrospective health claims data in Korea from 2012 to 2017 that were transformed into the Observational Medical Outcomes Partnership Common Data Model. The pooled proportion of
constipation diagnoses was 30.5% in all patients with CKD and 15.9%, 16.5%, 17.4%, 29.9%, and 43.3% in patients with CKD stages 1-5, respectively, suggesting a higher prevalence in advanced CKD. Patients receiving
peritoneal dialysis or
hemodialysis had the highest prevalence of
constipation, while transplant recipients showed a prevalence comparable to that of patients with early CKD. Patients with CKD had a significantly higher risk of
constipation than age- and sex-matched non-CKD individuals (range of odds ratio [OR]:1.66-1.90).
Laxative prescribing patterns differed by CKD severity. Osmotic agents were prescribed in more than half of patients with advanced CKD, while
magnesium salts and bulking agents were prescribed less frequently. The CKD patients with
constipation were more likely to be prescribed
constipation-inducing medications, including
antipsychotic and neurological medications. Our findings provide real-world
constipation and
laxative prescription status in the Korean CKD population, revealing a significantly higher risk of
constipation and different
laxative prescribing patterns in patients with CKD.