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Constipation in renal impairment — GPhC CRA MCQ

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HardGI TherapeuticsConstipation in renal impairmentGPhC CRA

A 84-year-old care home resident with CKD stage 4 is prescribed sodium phosphate enema for constipation. He has abdominal discomfort, no vomiting and eGFR 22 mL/min/1.73 m². What is the most appropriate alternative?

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Correct answer: D — Contact the prescriber to consider a safer bowel regimen in severe renal impairment

Phosphate enemas can cause serious electrolyte disturbances, especially in frail older people and renal impairment. Magnesium-containing laxatives may also be problematic in advanced CKD. A safer regimen should be agreed with the prescriber based on severity and red flags. Abdominal symptoms require assessment for impaction or obstruction if worsening.

Reference: BNF; NICE CKS