[The exocrine pancreatic function in chronic renal insufficiency (author's transl)]

Area of Science:

• Gastroenterology
• Nephrology
• Endocrinology

Background:

• Chronic renal insufficiency (CRI) affects multiple organ systems.
• Pancreatic exocrine dysfunction is a potential complication of CRI.
• The role of metabolic acidosis in CRI-induced pancreatic changes requires further elucidation.

Purpose of the Study:

• To investigate the exocrine pancreatic function in patients with varying stages of chronic renal insufficiency.
• To determine the relationship between serum creatinine levels and pancreatic secretory capacity.
• To explore the potential role of metabolic acidosis in altered pancreatic function.

Main Methods:

• Secretin-pancreozymin testing was performed on 46 non-dialyzed patients with CRI.
• Pancreatic function parameters (amylase secretion, total secretory volume, bicarbonate secretion) were measured.
• Results were statistically compared to a healthy reference group.

Main Results:

• Significantly reduced amylase secretion, total secretory volume, and bicarbonate secretion were observed in patients with serum creatinine > 4.0 mg%.
• No evidence of secondary hyperparathyroidism was found.
• A significant correlation was found between blood base excess and elevated serum creatinine levels.

Conclusions:

• Chronic renal insufficiency, particularly with elevated creatinine levels, is associated with impaired exocrine pancreatic function.
• Metabolic acidosis, exacerbated by low-protein diets, is implicated as a pathogenic factor in CRI-related pancreatic dysfunction and chronic pancreatitis.
• Further research is warranted to fully understand the mechanisms linking CRI and pancreatic exocrine changes.