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

Document Type : Original Article


1 Department of Clinical Pharmacy, Islamic Azad University-Pharmaceutical Sciences Branch, (IAUPS), Tehran, Iran

2 Nephrology Department, Islamic Azad University, Tehran Medical Branch, Tehran, Iran

3 Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University-Pharmaceutical Sciences Branch, (IAUPS), Tehran, Iran


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


Main Subjects