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

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