Peptic ulceration, gastric secretion, and renal transplantation.

Abstract

SummaryFifty-four patients on haemodialysis for chronic renal failure underwent renal transplantation. Basal and maximum acid output and the incidence of peptic ulcer before transplantation were not significantly different from those of controls. But after renal transplantation the incidence of symptoms of peptic ulcer was high (22%) and four out of six patients who developed gastrointestinal bleeding died from this complication.In men peak acid output was significantly increased after renal transplantation and was associated with a 30% incidence of symptoms of peptic ulcer compared with 10% in women, who showed no significant change in mean basal or peak acid output. Peptic ulceration after transplantation was not associated with steroid dosage, hyperparathyroidism, or the height of blood urea concentrations.Given criteria of a history of dyspepsia, abnormal barium meal findings, or gastric hypersecretion, it was not possible to identify patients at risk from peptic ulceration or life-threatening complications after renal transplantation. Thus the routine screening of these patients for peptic ulcer has no practical value, and the incidence of fatal complications is not high enough to justify routine prophylactic anti-ulcer surgery aimed at reducing acid secretion before renal transplantation.

Gastroduodenal lesions and Helicobacter pylori in children with end-stage renal disease

“…Undernutrition resulting from these symptoms contributes to poor growth of these children [1]. Although gastritis and gastroduodenal ulceration are well documented complications in adult hemodialysis (HD) patients and renal transplant recipients (RTR), data regarding gastrointestinal problems of chronic renal failure (CRF) in infancy and childhood are scarce [2][3][4][5][6].…”

Cimetidine in the treatment of peptic ulceration following renal transplantation

“…Fifteen per cent of our own patients, without dyspepsia during dialysis, developed symptoms within 3 months of transplantation; of these, 6 had gastrointestinal bleeding and 4 of them died (Chisholm et al, 1977). …”

Gastrointestinal Complications in Chronic Renal Failure

“…observ.]. On the other hand, regular dialysis and transplanta tion caused an increase in acid secretion [14] and in the sensitivity of acid secretion [48], This, in fact, could be one plausible reason for the increase in upper GI complications [41], Heparinization during dialysis, stress caused by transplantation, corticosteroids and other immunosuppressive treatment and infections can also add to the frequency of upper GI complications during active treatment of uremia.…”