Global Prevalence and Risk Factors of Constipation Among Patients Receiving Haemodialysis: A Systematic Review and Meta-Analysis

Background: Constipation significantly affects the quality of life and health outcomes of patients undergoing haemodialysis. Despite its common occurrence in this population, there is a lack of systematic reviews and meta-analyses on the prevalence of constipation among patients receiving haemodialysis. Objectives: To determine the global prevalence and risk factors of constipation among patients receiving haemodialysis. Design: A systematic review and meta-analysis following PRISMA guidelines. Participants: Adult patients undergoing haemodialysis. Methods: A comprehensive search strategy was conducted across PubMed, Embase, CINAHL, Web of Science, and Medline to identify relevant articles. A random-effects model was used with 95 confidence intervals. Heterogeneity, meta-regression, moderators, and publication bias were also analysed. The methodological quality was assessed according to Hoy's guidelines and the Risk of Bias tool 2.0. Risk factors were determined based on odds ratios, along with 95 confidence intervals or p-values. Results: Twenty-two studies involving 4963 patients receiving haemodialysis were included. The pooled prevalence of constipation among patients with haemodialysis was 42.2. The Asian region reported a significantly higher proportion of constipation than other regions. No publication bias was identified using Egger's test. The Rome criteria were mostly used among the included studies. Significant risk factors for constipation were diabetes and low levels of physical activity. Conclusion: Constipation is prevalent among patients with haemodialysis, affecting nearly half of this population, particularly in Asia. The Rome criteria were the predominant method used for diagnosing constipation. Diabetes and limited physical activity were significant risk factors for constipation. The findings emphasise the importance of healthcare professionals conducting regular screening and designing tailored interventions to effectively manage constipation in this population. © 2025 European Dialysis and Transplant Nurses Association/European Renal Care Association.