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

Abstract Introduction. Chronic kidney disease (CKD) is a major public health problem that often goes unrecognized until late-stage disease. Patients with chronic kidney disease (CKD) 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 could reduce 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. Materials and Methods. In this prospective before-after intervention 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. A P value less than 0.05 was considered significant. Results. 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 and uric acid were not significant. Conclusions. Lactulose administration in CKD patients could decrease levels of various deleterious elements especially urea and blood potassium, The daily use of lactulose in CKD patients e suggested in order to receive better therapeutic results.