The efficacy of

Objective: Chronic constipation (CC) is common in chronic kidney disease (CKD) patients. This study was performed to evaluate the efficacy of Materials and Methods: This randomized clinical trial was conducted on CKD patients with CC referred to nephrology clinics of Babol University of Medical Sciences in 2022-23.They were examined by a nephrologist and 66 patients were randomly allocated into two groups, receiving CFS or lactulose, with the same dosage (30 ml/day) for 2 weeks. Patients were visited in the 1 Results: In the CFS group, defecation frequency per week and daily (primary outcome) improved significantly compared to the lactulose group (p-Value=0.01).As secondary outcomes, the percent of straining, lumpy stools and stool hardness in the CFS group was significantly better than the lactulose (p <0.05). In the CFS group, blood urea nitrogen (BUN) (p-Value=0.045) and creatinine (Cr) (p =0.01) decreased after the intervention significantly. PAC-QOL showed significant improvements in subscales and total scores in the CFS group compared to the lactulose group (p<0.001). Conclusion: This is the first trial that evaluated CFS on CC in CKD patients, and monitored the changes in laboratory factors levels. CFS demonstrates greater efficacy than lactulose in managing CC among CKD patients. PAC-QOL was greatly better in CFS group rather than lactulose group.