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Pancreatic exocrine function in severe human chronic renal failure.
Gut
|May 1, 1982
Summary
Patients with chronic renal failure exhibit altered gastrointestinal hormones, leading to increased pancreatic trypsin secretion. This suggests stimulatory hormones, like cholecystokinin, dominate over inhibitory ones in kidney insufficiency.
Area of Science:
- Gastroenterology
- Nephrology
- Endocrinology
Background:
- Chronic renal failure (CRF) is associated with abnormal gastrointestinal hormone profiles.
- Elevated fasting serum concentrations of hormones with antagonistic effects on pancreatic exocrine function are observed in CRF patients.
Purpose of the Study:
- To investigate the predominant effect of stimulatory versus inhibitory gastrointestinal hormones on pancreatic exocrine function in CRF.
- To evaluate pancreatic exocrine secretion in response to duodenal mannitol perfusion and cholecystokinin stimulation in CRF patients.
Main Methods:
- Studied eight patients with severe CRF and eight age/sex-matched controls.
- Assessed pancreatic exocrine function during duodenal mannitol perfusion and continuous intravenous cholecystokinin infusion.
- Measured serum hormone levels and pancreatic enzyme outputs (trypsin, lipase).
Main Results:
- Patients with CRF showed significantly slower plasma clearance of cholecystokinin compared to healthy subjects (p=0.05).
- CRF patients exhibited hypersecretion of pancreatic trypsin in response to both mannitol perfusion and cholecystokinin stimulation (p<0.05).
- No significant differences in pancreatic lipase secretion were observed between CRF patients and controls.
Conclusions:
- Findings support the hypothesis that stimulatory gastrointestinal hormones predominate over inhibitory ones in CRF.
- The dissociation between trypsin and lipase secretion in CRF suggests a differential trophic effect of stimulatory hormones, such as cholecystokinin, on pancreatic enzyme secretion.
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