Skip to main content
Log in

Lesions of the upper gastrointestinal tract in patients with chronic renal failure

  • Original Article
  • Published:
Gastroenterologia Japonica Aims and scope Submit manuscript

Summary

Endoscopy of the upper gastrointestinal tract was performed on 84 patients with end-stage chronic renal failure undergoing hemodialysis. Gastric acid secretion and fasting plasma gastrin levels were also examined in these patients.

Hemorrhagic gastritis was most frequently observed (23 cases) followed by erosive gastritis (18 cases). No patients had gastric ulcers. Duodenal ulcers were observed in only two patients. Gastrointestinal bleeding was observed in 15 cases (17.9%). Thirteen of these 15 cases had hemorrhagic gastritis, one of which had a duodenal ulcer as a complication.

Fasting plasma gastrin levels (359.6 ± 336.5 pg/ml) were significantly higher than those of normal subjects (35.2 ± 37.1 pg/ml), but no acceleration in gastric acid secretion was observed either in the basal condition (BAO 0.8± 0.7 mEq/h) or following tetragastrin stimulation (MAO 9.0 ± 6.9 mEq/h).

Our results were inconsistent with the previous reports that high frequencies of peptic ulcers and increased gastric acid secretion were observed in patients with chronic renal failure.

Our data suggest that the defensive factors rather than the aggressive factors of the gastroduodenal mucosa may be involved in chronic renal failure.

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

Reference

  1. Shepherd AMM, et al: Peptic ulceration in chronic renal failure. Lancet 1: 1357, 1973

    Article  PubMed  CAS  Google Scholar 

  2. Goldstein H, et al: Gastric acid secretion in patients undergoing chronic dialysis. Arch Int Med 120: 645, 1967

    Article  CAS  Google Scholar 

  3. Ventkateswaran PS, et al: Gastric acid secretion in chronic renal failure. Brit MedJ 4: 22, 1972

    CAS  Google Scholar 

  4. Kodaka M: Speaking at the 12th meeting of society of hemodialysis in Japan. 1973. Cited by Mura T (1977)

  5. Newton WT, et al: The fate of intravenously administered radiolabeled gastrin. Surgery 69(1): 34, 1971

    PubMed  CAS  Google Scholar 

  6. Hjelmquist UBE, et al: Effect of the kidney on endogenous gastrin. Surg Forum 23: 318, 1972

    PubMed  CAS  Google Scholar 

  7. Davidson WD, et al: Uremia—A cause of fasting hypergastrinemia. Clin Res 19: 390, 1971

    Google Scholar 

  8. Korman NG, et al: Hypergastrinemia in chronic renal failure. Brit MedJ 1: 209, 1972

    Article  CAS  Google Scholar 

  9. Hansky J, et al: Serum gastrin in chronic renal failure, in “Gastrointestinal Hormones”, ed. by Thompson JC, Univ. of Texas Press, Austin and London, 1975, p 115

    Google Scholar 

  10. McConnell JB, et al: Gastric function in chronic renal failure: effects of maintenance hemodialysis. Lancet 2: 1121, 1975

    Article  PubMed  CAS  Google Scholar 

  11. Selye, H: The alarm reaction and the diseases of adaptation. Ann Int Med 29: 403, 1948

    PubMed  CAS  Google Scholar 

  12. Cushing H: Peptic ulcers and the interbrain. Surg Gynec Obstet 55: 1, 1932

    Google Scholar 

  13. Curling PB: On acute ulceration of the duodenum in cases of burns. Trans Med Chir Soc (London) 25: 260, 1942

    Google Scholar 

  14. Fletcher DG, et al: Acute peptic ulcer as a complication of major surgery, stress, or trauma. Surgery 36: 212, 1954

    PubMed  CAS  Google Scholar 

  15. Woldman EE: Acute ulcer of upper gastrointestinal tract their relation to systemic stress and adrenal damage. JAMA 149: 984, 1952

    CAS  Google Scholar 

  16. Berkowitz, et al: Acute peptic ulceration following cardiac surgery. Ann Intern Med 46: 6, 1957

    Google Scholar 

  17. McClelland RN, et al: Gastric secretory and splanchnic blood flow studies in man after severe trauma and hemorrhagic shock. Am J Surg 121: 134, 1971

    Article  PubMed  CAS  Google Scholar 

  18. Gerety DC, et al: Restraint-induced gastric erosions: Role of acid back diffusion. Am J Dig Dis 17: 1012, 1972

    Article  PubMed  CAS  Google Scholar 

  19. Gordon MJ, et al: Divergent nature of gastric mucosal permeability and gastric acid secretion in sick patients with general surgical and neurosurgical disease. Ann Surg 178: 285, 1973

    Article  PubMed  CAS  Google Scholar 

  20. Guth PH, et al: Microcirculatory and mast cell damages in restraint induced gastric ulcer. Gastroenterology50: 562, 1966

    PubMed  CAS  Google Scholar 

  21. Stremple JF: Prospective studies of gastric secretion in trauma patients. Am J Surg 131: 78, 1976

    Article  PubMed  CAS  Google Scholar 

  22. Skillman JJ, et al: Respiratory failure, hypotension, sepsis and jaundice; a clinical syndrome associated with lethal hemorrhage from acute stress ulceration of the stomach. AmJSurgll7: 523, 1969

    Google Scholar 

  23. Techan PE: On the genesis of uremia. Am J Med 48: 671, 1970

    Article  Google Scholar 

  24. Cohen BD: Uremic toxins. Bull NY Acad Med 51: 1228, 1975. Cited by Ueda Y (1976)

    CAS  Google Scholar 

  25. Krempien B, et al: Gastropathy in uremia, in “Longterm hemodialysis”, by Hampers LC, et al, Grune and Stratton CO., New York, 1973, p 82

    Google Scholar 

  26. Shapira N, et al: Gastric mucosal permeability and gastric acid secretion before and after hemodialysis in patients with chronic renal failure. Surgery 83(5): 523, 1978

    Google Scholar 

  27. Sun DCH: Etiology and pathology of peptic ulcer, in “Gastroenterology” Vol. 1, by Bockus HL, Saunders CO., Phyladelphia LondonTronto, 1974, p 579

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tani, N., Harasawa, S., Suzuki, S. et al. Lesions of the upper gastrointestinal tract in patients with chronic renal failure. Gastroenterol Jpn 15, 480–484 (1980). https://doi.org/10.1007/BF02773912

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02773912

Key Words

Navigation