Gastric Function in Chronic Renal Failure Effects of Maintenance Hæmodialysis

McConnell, J B; Þjóðleifsson, Bjarni; Stewart, W. K.; Ey, Kim

doi:10.1016/s0140-6736(75)91007-7

Cited by 43 publications

(13 citation statements)

References 18 publications

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“…It was interesting that all the 7 patients who showed an exaggerated response were males. It was also interesting that they did not have significantly elevated serum gastrin levels so that there does not seem to be a cause and effect relationship as has been suggested [15].…”

Section: Discussionmentioning

confidence: 88%

“…On the other hand, studies in which gastric acid output was measured concurrently have yielded conflicting results. Some studies have reported hyperchlorhydria [9,11] while others have reported normal or low acid output [3][4][5]12], Raised levels of urea have been implicated in the pathogenesis of gastric hyposecretion [13,14], and hemo dialysis has been said to correct the impaired gastric secretory capacity and even to unmask hyperchlorhydria [15]. On the other hand, achlorhydria, although encoun tered [9,12,16] has been given scant attention.…”

mentioning

confidence: 99%

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Gastric Acid Secretion and Serum Gastrin Levels in Patients with Chronic Renal Failure on Regular Hemodialysis

Gold

Morley

Viljoen

et al. 1980

Nephron

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Previous studies of gastric secretory function and serum gastrin levels in patients with chronic renal failure (CRF) have yielded conflicting results. In a study of 30 patients on regular hemodialysis, serum gastrin levels were higher than normal (p < 0.05), and the gastric secretory response to pentagastrin was normal for the group as a whole. There were, however, 8 patients who were hypochlorhydric (4 achlorhydric) and 7 who were hyperchlorhydric. The patients with gastric hyposecretion were older, predominantly male and this group was associated with the highest gastrin levels as well as the highest incidence of gastrointestinal hemorrhage. Chronic gastritis is thus more common in CRF than generally believed and may be responsible for much of the morbidity from gastrointestinal complications during hemodialysis.

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Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

Gastric Acid Secretion and Serum Gastrin Levels in Patients with Chronic Renal Failure on Regular Hemodialysis

Gold

Morley

Viljoen

et al. 1980

Nephron

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“…A limited number of small studies have suggested that gastric acid hypersecretion and hypergastrinemia exist in a subset of patients on hemodialysis. [18][19][20] Overall, the findings suggest that it is therapeutically important to avoid using systemic anticoagulation during dialysis in both the acute and convalescent phases of recent PUD bleeding for the ESRD patient. Because ESRD patients with low-risk ulcer stigmata also have this marked elevation in rebleeding, this group should be managed as high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease

Cheung

LaBossière

et al. 2010

Gastrointestinal Endoscopy

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“…Previous investigators approached the problem through evaluation of only some of these factors; some estimated SG in acute renal patients only [II], while others estimated SG in CRF with or without respect to degree of renal failure, or to the effect of treatment [ 13,27,32,41 ]. Secretory functions of the stomach have also been studied [12,18,20,47] and their relation to SG levels have also been documented [14-17, 23, 27, 32, 43, 46.…”

Section: Discussionmentioning

confidence: 99%

Serum Gastrin in Chronic Renal Failure: Morphological and Physiological Correlations

Ghonaimy¹,

Barsoum²,

Soliman³

et al. 1985

Nephron

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Elevated serum gastrin (SG) has been reported in chronic renal failure (CRF). We studied SG levels in relation to various humoral and gastroduodenal histopathologic findings in 20 controls, 12 uremics under conservative therapy (CT), 27 patients on regular dialysis (RDT) and 8 transplanted patients (Tx). SG and parathyroid hormone (PTH) levels were estimated by radioimmunoassay (RIA), in addition serum BUN, creatinine, Ca ⁺⁺PO₄^---and alkaline phosphatase (predialysis in RDT) were determined. 20 patients (12 on CT and 8 on RDT) underwent pentagastrin (PG) stimulation test and upper gastrointestinal endoscopy with biopsy of gastric and duodenal mucosa. The mucosal samples were stained for mucopolysaccharides (MPS), nucleic acid (NA) and alkaline phosphatase (AP), and divided into intense, normal or faint staining. Mean SG was 688.71 pg/ml (CT cases), 636.2 pg/ml (RDT cases) and 280.6 pg/ml (Tx cases), all values being significantly higher than controls (118.46 pg/ml). SG level had a linear correlation with serum creatinine in CT patients and predialysis creatinine in RDT patients, but not with other parameters studied (BUN, Ca ⁺⁺, PTH, PO₄^---AP). The incidence of gastroduodenal erosions (40%) had a significant negative correlation with SG. They were more frequent with normal MPS stain (p = 0.01) and NA staining (p < 0.001) than faint staining of gastric mucosa biopsy. The acid response to PG stimulation was inversely correlated with SG. We believe that elevated SG is compensatory to a decreased response of the gastroduodenal mucosa to PG. Mere retention of SG does not explain its elevation as its correlation with serum creatinine existed not only in patients on CT, but also in RDT patients. The apparently protective effect of elevated SG against gastric mucosal erosions may be partially related to its effect on gastric motility with diminution of biliary reflux. Gastric mucosal erosions seem to occur in a relatively healthy mucosa with low SG, serum calcium or PTH.

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Gastric Function in Chronic Renal Failure Effects of Maintenance Hæmodialysis

Cited by 43 publications

References 18 publications

Gastric Acid Secretion and Serum Gastrin Levels in Patients with Chronic Renal Failure on Regular Hemodialysis

Gastric Acid Secretion and Serum Gastrin Levels in Patients with Chronic Renal Failure on Regular Hemodialysis

Peptic ulcer bleeding outcomes adversely affected by end-stage renal disease

Serum Gastrin in Chronic Renal Failure: Morphological and Physiological Correlations

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