Gastric function and histology in chronic renal failure

Area of Science:

• Gastroenterology
• Nephrology
• Pathology

Background:

• Chronic renal failure (CRF) is associated with various systemic complications.
• Gastrointestinal abnormalities are frequently observed in CRF patients but require further investigation.

Purpose of the Study:

• To investigate gastric function and histology in patients with untreated CRF.
• To assess the impact of renal replacement therapy on gastrointestinal pathology.

Main Methods:

• Endoscopic examination of the stomach and duodenum in 24 CRF patients.
• Histological analysis of biopsies from standard gastric and duodenal sites.
• Measurement of stimulated gastric acid secretion and serum gastrin levels.

Main Results:

• All patients had gastritis; 17 had duodenitis. Oesophagitis was present in nine patients.
• Gastric acid secretion was impaired in seven patients and hypersecreted in two.
• Elevated fasting serum gastrin levels were observed in 12 of 19 patients.
• Atrophic gastritis correlated with low acid output and hypergastrinaemia.
• Patients with extensive gastritis showed more severe renal failure and reduced acid secretion.
• Three patients demonstrated significant endoscopic and histological improvement after dialysis or transplantation.

Conclusions:

• Untreated chronic renal failure is frequently associated with significant upper gastrointestinal inflammation and altered gastric acid secretion.
• Gastrin levels are often elevated in CRF patients, particularly those with atrophic gastritis.
• Renal replacement therapy can lead to substantial improvement in gastric and duodenal pathology.