Effect of Lactulose on the Intestinal Flora of Elderly Constipation Patients With Chronic Renal Insufficiency

Objectives To evaluate the efficacy of lactulose in the treatment of elderly constipation patients with chronic renal insufficiency and its influence on renal function. Methods They were divided into the lactulose group ( n = 30) and polyethyleneglycol (PEG) group ( n = 26). The lactulose group was given 15 mL oral lactulose qd × 4 weeks, and the PEG group was given PEG 4000 powder 10 g qd × 4 weeks. Wexner constipation score and Bristol stool type were recorded before and after the intervention. To evaluate the efficacy of lactulose and PEG in improving constipation in elderly patients with chronic constipation with renal insufficiency. Results Both lactulose and PEG could improve the symptoms of constipation, and no significant difference was observed ( p = 0.995). After lactulose treatment for 4 weeks, the serum levels of creatinine, uric acid, and IL‐6 reduced significantly ( p < 0.050), but they remained unchanged after treatment with PEG for 4 weeks ( p > 0.050). At the genus level, the abundance of Anaerofustis stercorihominis (related to the production of short‐chain fatty acids) increased markedly ( p < 0.050), and the abundance of Halomonadaceae (related to the production of uremic toxins), Eikenella (one of the opportunistic pathogenic bacteria), and Sphingomonas (related to nitrogen metabolism) reduced significantly after lactulose treatment. Conclusion Lactulose can improve renal function, mild inflammation, and gut microbiota in these patients. We speculate that the improvement of renal function after lactulose treatment may be related to the improvement of gut microbiota and systemic mild inflammation.