Gastric emptying in chronic renal failure.

McNamee, P; Moore, G.; McGeown, Mary G.; Doherty, C C; Collins, B. J.

doi:10.1136/bmj.291.6491.310

Cited by 67 publications

(34 citation statements)

References 6 publications

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“…Only a few studies (Lin et al, 1997;Ko et al, 1998;Lee et al, 2000) have investigated gastric myoelectrical activity in patients with CRF. On the other hand, several studies evaluating gastric emptying in patients with CRF have yielded conflicting results; in some of these (Brown-cartwright et al, 1988;Dumitrascu et al, 1995;Kao et al, 1996;Van Vlem et al, 2001;Hubalewska et al, 2004) gastric emptying was found to be delayed, while in others (Wright et al, 1984;McNamee et al, 1985;Soffer et al, 1987) it remained unchanged. In most of these studies, it is not clear whether the patients were receiving dialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports (Brown-cartwright et al, 1988;Dumitrascu et al, 1995;Kao et al, 1996;Van Vlem et al, 2001;Hubalewska et al, 2004;Wright et al, 1984;McNamee et al, 1985;Soffer et al, 1987) evaluating gastric emptying in patients with CRF have yielded conflicting results. The discrepancies among these findings may be attributed to the methods used to measure gastric emptying or differences in the patients' conditions (i.e., on hemodialysis, on continuous ambulatory peritoneal dialysis, or at the predialysis stage).…”

Section: Introductionmentioning

confidence: 99%

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Improvement of gastric motility by hemodialysis in patients with chronic renal failure

Adachi

Kamiya

Hirako

et al. 2007

J. Smooth Muscle Res.

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Background: Gastrointestinal (GI) symptoms are common in patients with chronic renal failure (CRF). We have previously demonstrated that patients with predialysis endstage renal disease showed a high prevalence of GI symptoms and gastric hypomotility, and that gastric hypomotility appears to be an important factor in generating GI symptoms. However, it is not clear whether impaired gastric motor function would improve after hemodialytic treatment. Aims: To examine the relationship between gastric motor function and GI symptoms in CRF patients on hemodialysis. Methods: The study was performed in 19 patients with CRF treated with hemodialysis for more than six months and in 12 matched healthy controls. GI symptom severity was quantified in all patients. Gastric motility was evaluated with cutaneously recorded electrogastrography (EGG) and gastric emptying of semi-solid meals using the 13 C-acetic acid breath test. Results: Six patients had no symptoms, and 11 had slight GI symptoms with a total symptom score of less than 5. Compared with controls, CRF patients revealed no differences in gastric motility parameters, with the exception of a lower percentage of normogastria in EGG at fasting state. Eleven patients had normal gastric motor function (Group A), and eight showed abnormalities of either gastric myoelectrical activity or gastric emptying (Group B). There was no difference in symptom score between Group A and Group B. Conclusions: More than half of the patients with CRF on hemodialysis demonstrated normal gastric motility, and no or slight GI symptoms. Hemodialytic treatment may improve impaired gastric motility and reduce GI symptoms in patients with CRF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of gastric motility by hemodialysis in patients with chronic renal failure

Adachi

Kamiya

Hirako

et al. 2007

J. Smooth Muscle Res.

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“…CAPD patients with a full peritoneal cavity can have a significant delay in gastric emptying of indigestible solids (5). This phenomenon is not observed when the peritoneal cavity is drained (5), nor has it been observed in hemodialysis and predialysis patients with end-stage renal disease (16,23). However, it is uncertain whether gastric emptying of liquids and digestible solids is similarly delayed, because the digestive mechanisms differ from that for indigestible solids (17).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and ex vivo susceptibility of cefpodoxime proxetil in patients receiving continuous ambulatory peritoneal dialysis

Johnson

Ateshkadi

Zimmerman

et al. 1993

Antimicrob Agents Chemother

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Pharmacokinetics of cefpodoxime, an extended-spectrum cephalosporin, were determined for eight noninfected patients on continuous ambulatory peritoneal dialysis (CAPD) and eight healthy volunteers. Subjects were matched for sex, age (±6 years), and body weight (+10 kg, except for one pair) and received a single 200-mg (cefpodoxime equivalents) oral dose of the prodrug cefpodoxime proxetil in an open-label, paireddesign fashion. Dialysate (CAPD group only), plasma, and urine samples were collected and assayed for cefpodoxime by a microbiologic method. In addition, mean bactericidal titers of the effluent dialysate against selected bacterial strains often associated with CAPD-related peritonitis were determined at 6 and 24 h after the dose. There was a significant difference (P < 0.05) in all pharmacokinetic parameters between healthy and CAPD subjects, except for lag time to absorption. The mean peak plasma cefpodoxime concentration of 1.88 0.6 ,uglml occurred at 2.44 + 0.5 h for healthy volunteers, while the peak concentration of 3.25 1.4 ,Lg/ml occurred at 12.0 + 4.2 h for patients on CAPD. The average elimination half-life in CAPD patients was approximately 12 times greater than that seen in healthy volunteers. Peritoneal dialysis had a minimal effect on cefpodoxime clearance. In healthy volunteers, 24.2% 13% of the dose was recovered from the urine, in contrast to only 5.59%o ±e 6.9%o for CAPD patients. The mean bactericidal titers for all CAPD patients, at 6 and 24 h, were mostly less than 1:2 and did not exceed 1:4 for any of the isolates. Because of the decreased renal clearance and negligible dialysate clearance of cefpodoxime, and delayed drug absorption, the dosage interval for cefpodoxime proxetil may need to be extended in CAPD patients.

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“…Hemoglobin (Hb), blood urea nitrogen (BUN), serum creatinine, blood glucose, total protein, albumin, total cholesterol (t-chol), HDL-cholesterol (HDL), LDL-cholesterol (LDL), VLDL-cholesterol (VLDL), triglyceride, sodium (Na + ), potassium (K ), phosphorus (P), intact parathyroid hormone (iPTH), ferritin, vitamin B 12 (vitB 12 ), and folic acid were collected for each patient from patient files at the same time of the study and then three months later. The mean value of the two different tests were calculated and used for the statistics.…”

Section: Biochemical Analysis and Anthropometric Measurementsmentioning

confidence: 99%

Gastric Emptying in Patients on Renal Replacement Therapy

et al. 2004

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In addition to gastrointestinal tract symptoms such as nausea, vomiting, and loss of appetite, impaired gastric emptying time (GET) may be related to nutritional parameters and nutritional status of patients on renal replacement therapy (RRT). Patients on RRT are affected by several factors such as uremic toxins, the presence of dialysate in the peritoneal cavity, and the drugs used against renal allograft rejection. In this study, we investigated the gastric emptying time and its relationship with biochemical and nutritional parameters in patients on RRT: those on hemodialysis and peritoneal dialysis, and renal transplantation patients. Seventy-five patients, 44 on hemodialysis, 16 on peritoneal dialysis, and 15 renal transplant patients, were included in the study. They were examined for gastric emptying time using a radioisotopic method. The results were compared with the GET of healthy subjects. Each group of patients was evaluated in terms of hemoglobin, hematocrit, blood urea nitrogen (BUN), creatinine, blood glucose, total protein, albumin, serum lipids, parathyroid hormone (PTH) and body mass index and biceps and triceps skinfold. The mean GET of patients on RRT was significantly longer than the mean GET of healthy subjects (87.8 ± 23.4 vs. 55 ± 18 min, p < 0.05). The mean GET of each therapy subgroups was significantly longer than the healthy subjects (the mean GET was 85.1 ± 22.4 min for hemodialysis, 87.7 ± 31.8 min for peritoneal dialysis, and 94.6 ± 16.7 min for renal transplant patients, respectively, p < 0.05). On the other hand, the differences in the mean GET between the three therapy subgroups were not statistically significant ( p > 0.05). In addition, time on replacement therapy inversely and blood glucose positively correlated with GET in renal transplant patients. In conclusion, GET was www.dekker.com longer in patients on all three RRT modalities than in healthy subjects. GET was not significantly different in dialysis patients and renal transplant patients.

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Gastric emptying in chronic renal failure.

Cited by 67 publications

References 6 publications

Improvement of gastric motility by hemodialysis in patients with chronic renal failure

Improvement of gastric motility by hemodialysis in patients with chronic renal failure

Pharmacokinetics and ex vivo susceptibility of cefpodoxime proxetil in patients receiving continuous ambulatory peritoneal dialysis

Gastric Emptying in Patients on Renal Replacement Therapy

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