Abstract: 【abstract】Objective To explore the effects of probiotics to treat chronic constipation on intestinal microbiota and quality of life in maintenance hemodialysis (MHD) patients. Methods Ninety patients were randomly divided into probiotic group (n=45) and control group (n=45). The patient assessment of constipation quality of life questionnaire (PAC- QOL), intestinal microbiota, serum inflammatory factors and renal function indicators were detected and analyzed before the treatment and after the treatment for one month. Results ①After the treatment, Scr, BUN, and UA decreased in both groups (control group: t=7.933, 13.190 and 4.176 respectively, P<0.001; probiotic group: t=7.721, 12.722 and 5.948 respectively, P<0.001); BUN was lower in probiotic group than in control group (t=3.217, P=0.002), but Scr and UA had no statistical significances between the two groups (t=0.003 and 0.258, P=0.997 and 0.776). ②After the treatment, the numbers of intestinal bifidobacteria and lactobacilli increased and E. coli and enterococci decreased in both groups, with the changes more prominent in probiotic group than in control group (t=-9.367, -22.573, 35.796, and 6.124 respectively, P<0.001). In control group after the treatment, the number of bifidobacteria had no significant change (t=1.984, P=0.054), but intestinal lactobacilli increased and E. coli and enterococci decreased (t=-4.239, 6.633 and 7.466 respectively, P<0.001); In probiotic group after the treatment, the increase of intestinal bifidobacteria and lactobacilli and decrease of E. coli and enterococci were statistically significant (t=- 10.759, - 30.592, 37.157 and 9.010 respectively, P<0.001). ③ Serum IL- 6 and CRP decreased after the treatment in both groups (t=122.371 and 3.489, P<0.001), with the decrease more in probiotic group. ④After the treatment PAC-QOL improved in the domains of body discomfort, psychological and social inadaptation, worrying and anxiety, satisfaction score, and total score in both groups (t=24.216, 13.26, 34.175, 49.925 and
34.553 respectively, P<0.001), with the improvements more in probiotic group. Conclusion Probiotics can be beneficial in improving the intestinal microbiota imbalance and the micro-inflammatory state but had no obvious effect on renal function in MHD patients with chronic constipation. Probiotics can also reduce the PAC-QOL score and improve the chronic constipation symptoms in these patients.

Key words: Intestinal microbiota, Chronic constipation, Self-assessment form for quality of life, Maintenance hemodialysis, Probiotics