Skip to main content
Log in

Gastric and pancreatic functions in haemodialyzed patients

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

The aim of this work was to assess gastric acid secretion in relation to morphological and histological changes in the gastric mucosa as well as prevalence ofHelicobacter pylori in chronically haemodialyzed uraemic patients. Exocrine pancreatic functions after secretin-cerulein test were also studied. In haemodialyzed patients low basal gastric acid output was found, whereas peak output after pentagastrin stimulation did not differ significantly when compared to controls. Endoscopy of gastric and duodenal mucosa revealed inflammatory changes in the majority of patients, described histologically as chronic gastritis with duodenitis.Helicobacter pylori antigen was detected in the serum of 45% of uraemic patients. Serum amylase activity was elevated in haemodialyzed patients relative to controls. Although clinically asymptomatic, haemodialyzed patients exhibited various degrees of gastrointestinal mucosal abnormalities and impairment in exocrine pancreatic functions, mainly low stimulated bicarbonate and protein output as well as low electrolyte concentrations in duodenal content.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wee, A., Kang, J. Y., Ho, M. S., Choong, H. L., Wu, A. Y. T., Sutherland, I. H.: Gastroduodenal mucosa in uraemia: Endoscopic and histological correlation and the prevalence of Helicobacter-like organisms.Gut, 31, 1093 (1990).

    PubMed  CAS  Google Scholar 

  2. Mason, E. E.: Gastrointestinal lesions occuring in uraemia.Ann. Intern. Med., 37, 96 (1952).

    PubMed  CAS  Google Scholar 

  3. Bartos, V., Melichar, J., Erben, J.: The function of exocrine pancreas in chronic renal disease.Digestion, 3, 33 (1970).

    Article  PubMed  CAS  Google Scholar 

  4. Keogh, J. B., McGeeney, K. F., Drury, M. I., Counihan, T. B., O'Donnel, M. D.: Renal clearance of pancreatic and salivary amylase relative to creatinine in patients with chronic renal insufficiency.Gut, 19, 1125 (1978).

    PubMed  CAS  Google Scholar 

  5. Otte, M., Stahlheber, H., Forell, M. M., Dobbelstein, H., Richert, J., Thurmayer, R., Thurmayer, G. R.: Exokrine Pankreasfunktion bei chronischer Nierenisuffizienz.Klin. Wochenschr., 53, 67 (1975).

    Article  PubMed  CAS  Google Scholar 

  6. Avram, M. M., Iancu, M.: Pancreatic disease in uremia and parathyroid hormone excess.Nephron, 32, 60 (1982).

    PubMed  CAS  Google Scholar 

  7. Vaziri, N. D., Dure-Smith, B., Miller, R., Mirahmadi, M.: Pancreatic pathology in chronic dialysis patients—An autopsy study of 78 cases.Nephron, 46, 347 (1987).

    Article  PubMed  CAS  Google Scholar 

  8. Abu-Alfa, A., Ivanovich, P., Mujais, S. K.: Uremic exocrine pancreatopathy.Nephron, 46, 94 (1988).

    Google Scholar 

  9. Baggenstoss, A. H.: The pancreas in uremia: A histopathologic study.Am. J. Pathol., 24, 1003 (1948).

    PubMed  CAS  Google Scholar 

  10. El Ghonaimy, E., Barsoum, R., Soliman, M., El Fikky, A., Rashwan, S., El Rouby, O., Hadolad, S., El Khashab, O., Abou Zeid, M., Hassaballah, N., Hassaballah, A.: Serum gastrin in chronic renal failure: Morphological and physiological correlations.Nephron., 39, 86 (1985).

    PubMed  Google Scholar 

  11. Muto, S., Murayama, N., Asano, Y., Hosoda, S., Miyata, M.: Hypergastrinemia and achlorhydria in chronic renal failure.Nephron, 40, 143 (1985).

    PubMed  CAS  Google Scholar 

  12. Gold, C. H., Morley, J. E., Hljoen, M., OuTim, L., de Fomseca, M., Kalk, W. J.: Gastric acid secretion and serum gastrin levels in patients with chronic renal failure on regular hemodialysis.Nephron, 225, 92 (1980).

    Google Scholar 

  13. Royse, V. L., Jensen, D. M., Corwin, H. L.: Pancreatic enzymes in chronic renal failure.Arch. Intern. Med., 147, 537 (1987).

    Article  PubMed  CAS  Google Scholar 

  14. Vaziri, N. D., Chang, D., Malekpoier, A., Radaht, S.: Pancreatic enzymes in patients with end-stage renal disease maintained on hemodialysis.Am. J. Gastroenterol., 83, 410 (1988).

    PubMed  CAS  Google Scholar 

  15. Vaziri, N. D., Dure-Smith, B., Miller, R., Mirahmadi, M. K.: Pathology of gastrointestinal tract in chronic hemodialysis patients; an autopsy study of 78 cases.Am. J. Gastroenterol., 80, 608 (1985).

    PubMed  CAS  Google Scholar 

  16. Milito, G., Taccone-Gallucci, M., Brunaleone, C., Naroli, F., Cesca, D., Boffo, V., Casciani, C. U.: The gastrointestinal tract in uremic patients on longterm hemodialysis.Kidney Int., 28 (Suppl. 17), S157 (1985).

    Google Scholar 

  17. Whitehead, R., Truelove, S. G., Gear, M. W. L.: The histological diagnosis of chronic gastritis in fiberoptic gastroscope biopsy specimens.J. Clin. Pathol., 25, 1 (1972).

    PubMed  CAS  Google Scholar 

  18. Whitehead, R., Roca, M., Meikle, D. D., Skinner, J. M., Truelove, S. G.: The histological classification of duodenitis in fiberoptic biopsy specimens.Digestion, 13, 129 (1975).

    PubMed  CAS  Google Scholar 

  19. Paimela, H., Stenman, S., Kekki, M., Sipponen, P., Tallgren, L. G., Scheinin, T. M.: Chronic gastritis and gastric secretion in uraemic and renal transplant patients.Hepatogastroenterol., 32, 15 (1985).

    CAS  Google Scholar 

  20. Doherty, C. C., Mc Geown, M. G.: Peptic ulceration, gastric acid secretion and kidney transplantation.Dial. Transplant., 8, 970 (1979).

    Google Scholar 

  21. Garg, A. K., Gulati, P. D., Misra, R. C., Saha, M. M., Rizvi, S. N. A., Chauhan, L. C.: Gastric functions in chronic uremia and effects of dialysis.Indian. J. Gastroenterol., 3, 73 (1984).

    PubMed  CAS  Google Scholar 

  22. Gordon, E. M., Johnson, A. G., Williams, G.: Gastric assessment of preoperative renal transplant patients.Lancet, i, 226 (1972).

    Article  Google Scholar 

  23. Taylor, I. L., Sells, R. A., Mc Connell, R. B., Dockray, G. J.: Serum gastrin in patients with chronic renal failure.Gut, 21, 1062 (1980).

    PubMed  CAS  Google Scholar 

  24. Sullivan, S. N., Tustanoff, E., Slaughter, D. N.: Hypergastrinemia and gastric acid hypersecretion in uremia.Clin. Nephrol., 5, 25 (1976).

    PubMed  CAS  Google Scholar 

  25. Korman, M. G., Laver, M. C., Hansky, J.: Hypergastrinemia in chronic renal failure.Br. Med. J., 1, 209 (1972).

    PubMed  CAS  Google Scholar 

  26. Ven Kateswaran, P. S., Jeffers, A., Hocken, A. G.: Gastric acid secretion in chronic renal failure.Br. Med. J., 4, 22 (1972).

    Google Scholar 

  27. Doherty, C. C.: Gastric secretion in chronic uremia and after renal transplantation.Ir. J. Med. Sci., 149, 5 (1980).

    PubMed  CAS  Google Scholar 

  28. Ala-Kaila, K., Kataja, M., Keyriläinen, O., Pasternack, A.: The gastrin secretion profile of patients with chronic renal failure.Ann. Clin. Res., 13, 65 (1981).

    PubMed  CAS  Google Scholar 

  29. Lieber, C. S., Lefevre, A.: Ammonia as a source of gastric hypoacidity in patients with uremia.J. Clin. Invest., 38, 1271 (1959).

    PubMed  CAS  Google Scholar 

  30. Grace, S. G., Davidson, W. D., State, D.: Renal mechanisms for removal of gastrin from circulation.Surg. Forum., 25, 323 (1974).

    PubMed  CAS  Google Scholar 

  31. Kang, J. Y., Wu, A. Y. T., Sutherland, I. H., Vathsala, A.: Prevalence of peptic ulcer in patients undergoing maintenance hemodialysis.Dig. Dis. Sci., 33, 774 (1988).

    Article  PubMed  CAS  Google Scholar 

  32. Margolis, D. M., Saylor, J. L., Geisse, D., De Schryrer-Kecskemeti, K., Harter, H. R., Zuckerman, G. R.: Upper gastrointestinal disease in chronic renal failure.Arch. Intern. Med., 138, 1214, (1978).

    Article  PubMed  CAS  Google Scholar 

  33. Mitchell, C. J., Jewel, D. P., Lewin, M. R., Mc Laughlin, J. E., Moorhead, J. F.: Gastric function and histology in chronic renal failure.J. Clin. Pathol., 322, 208 (1979).

    Google Scholar 

  34. Rovelstad, R. A.: The incompetent pyloric sphincter. Bile and mucosal ulceration.Am. J. Dis., 21, 165 (1976).

    Article  CAS  Google Scholar 

  35. Mc Connell, J. B., Stewart, W. B., Thjodleifsson, B., Wormsley, K. G.: Gastric function in chronic renal failure. Effects of maintenance hemodialysis.Lancet, ii, 1121 (1975).

    Article  Google Scholar 

  36. Murakami, M., Yoo, J. K., Mijuno, M., Saita, K., Inada, M., Miyake, T.: Role of gastric ammonia urea, and urease in gastric mucosal lesions in azotemia.Gastroenterology, 92, 1545A (1987).

    Google Scholar 

  37. Kim, H., Park, C., Jang, W. I.: The gastric juice urea and ammonia levels in patients with Campylobacter pylori.Am. J. Clin. Pathol., 94, 187 (1990).

    PubMed  CAS  Google Scholar 

  38. Gladziwa, U., Haase, G., Handt, S., Riehl, J., Wiethdtz, H., Dakshimamurty, K. V., Glöckner, W. M., Sieberth, H. G.: Prevalence of Helicobacter pylori in patients with chronic renal failure.Nephrol. Dial. Transplant., 8, 301 (1993).

    PubMed  CAS  Google Scholar 

  39. Shousha, S., Arnauta, A. H., Abbas, S. H., Parkins, R. A.: Antral Helicobacter pylori in patients with chronic renal failure.J. Clin. Pathol., 43, 397 (1990).

    PubMed  CAS  Google Scholar 

  40. Triebling, A. T., Korsten, M. A., Dlugosz, J. W., Paronetto, F., Lieber, I. S.: Severity of Helicobacter-induced gastric injury correlates with gastric juice ammonia.Dig. Dis. Sci., 36, 1089 (1991).

    Article  PubMed  CAS  Google Scholar 

  41. Noda, A.: Renal handling of amylase: Evidence for reabsorption by stop-flow analysis.Metabolism, 21, 351 (1972).

    Article  PubMed  CAS  Google Scholar 

  42. Pasternack, A., Klockars, M.: Clearance ratios of amylase and isoamylase to creatinine in renal disease.Clin. Nephrol., 9, 25 (1978).

    PubMed  CAS  Google Scholar 

  43. Farnzin, G., Musola, R., Mencarelli, R.: Morphological changes of the gastroduodenal mucosa in regular dialysis uraemic patients.Histopathology, 6, 429 (1982).

    Google Scholar 

  44. Poll, W. M., Werner, J., Huber, W., Kempmann, G., Willing, F.: Exokrine Pankreasfunktion bei chronischer Niereninsuffizienz.Z. Gastroent., 17, 177 (1979).

    CAS  Google Scholar 

  45. Moses, R., Panebianco, P., Dinoso, V. P., Chey, W. Y., Kostman, J. R., Clearfield, H. R., Murthy, S. N. S.: Decreased pancreatic bicarbonate responsiveness to graded doses of secretin in end-stage renal disease (Abstract).Gastroenterology, 86, 1190 (1984).

    Google Scholar 

  46. Wittich, K. A., Schmidt, H., Scheler, F., Creutzfeldt, W.: Exokrine Pankreasfunktion bei chronischer Niereninsuffizienz.Verh. dt. Ges. Inn. Med., 74, 1072 (1968).

    CAS  Google Scholar 

  47. Sachs, E. F., Hurwitz, F. J., Bloch, H. M., Milne, F. J.: Pancreatic exocrine hypofunction in the wasting syndrome of end-stage renal disease.Am. J. Gastroenterol., 78, 170 (1983).

    PubMed  CAS  Google Scholar 

  48. Owyang, C., Miller, L. J., Di Magno, E. P., Mitchell, J. C., Go, V. L. W.: Pancreas exocrine function in severe, human chronic renal failure.Gut, 23, 357 (1982).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Malyszko, J., Sosnowski, S., Mazerska, M. et al. Gastric and pancreatic functions in haemodialyzed patients. International Urology and Nephrology 27, 471–478 (1995). https://doi.org/10.1007/BF02550086

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02550086

Keywords

Navigation