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Gastrointestinal function, morphology, and immune status in uremia.
S el-Lakany1, P K Eagon, J S Gavaler
1Division of Gastroenterology (Medicine), University of Pittsburgh, School of Medicine, Pennsylvania 15261.
Nutrition (Burbank, Los Angeles County, Calif.)
|November 1, 1990
Summary
Gastrointestinal function in chronic renal failure (CRF) patients appears largely normal, despite some reduced enzyme activity. Advances in uremic patient management may explain these findings, contrasting with previous studies on kidney disease patients.
Area of Science:
- Nephrology
- Gastroenterology
- Uremic Physiology
Background:
- Chronic renal failure (CRF) is often associated with gastrointestinal (GI) issues like dyspepsia and bacterial overgrowth.
- Previous research suggested significant GI dysfunction in uremic patients.
Purpose of the Study:
- To investigate gastrointestinal function in patients with chronic renal failure.
- To compare GI function between uremic patients and healthy controls.
- To explore the impact of modern uremic patient management on GI function.
Main Methods:
- Studied 11 uremic patients (dialysis and non-dialysis) and 10 healthy controls.
- Assessed GI endoscopic findings, oral-cecal transit times, and intestinal mucosal lymphocyte subpopulations.
- Measured activities of mucosal disaccharidases (sucrase, maltase, lactase) and peptidases.
Main Results:
- No significant difference in nutritional status between patients and controls.
- Abnormal endoscopic findings in 7 patients, but none severe; prolonged oral-cecal transit times observed.
- Reduced sucrase and maltase activity noted, but no carbohydrate malabsorption.
- Normal intestinal mucosal lymphocyte populations and peptidase activities.
Conclusions:
- Gastrointestinal function is essentially normal in patients with chronic renal failure.
- Reduced disaccharidase activity does not lead to malabsorption due to intestinal reserve.
- Improved clinical management of uremic patients may explain the observed normality in GI function.