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Gastrointestinal function in chronic renal failure

¹Department of Paediatrics, University of Brescia, Italy.

Pediatric Nephrology (Berlin, Germany)

|December 1, 1995

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Gastrointestinal issues like vomiting and feeding problems are common in children with chronic renal failure (CRF), impacting growth. Addressing these complex motility disorders requires targeted pharmacological and nutritional interventions for better outcomes.

Area of Science:

Pediatric Nephrology
Gastroenterology
Clinical Nutrition

Background:

Feeding problems, anorexia, and vomiting are prevalent in pediatric chronic renal failure (CRF), significantly contributing to growth failure.
Gastroenterological and nutritional aspects of pediatric CRF are understudied, leading to empirical and often ineffective treatments.
Peptic diseases are common in adults with CRF, though the role of Helicobacter pylori is minimal; gastroesophageal reflux and motility disorders are key concerns in children.

Purpose of the Study:

To investigate the gastroenterological and nutritional challenges in infants and children with chronic renal failure (CRF).
To explore the role of gastrointestinal motility disorders, hormonal imbalances, and humoral alterations in pediatric CRF.
To highlight the need for specific interventions for vomiting and feeding problems in pediatric CRF.

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Main Methods:

Review of existing literature on gastroenterological and nutritional issues in pediatric CRF.
Analysis of common gastrointestinal symptoms such as vomiting, anorexia, and feeding difficulties.
Examination of potential contributing factors including gastro-oesophageal reflux, delayed gastric emptying, and humoral abnormalities.

Main Results:

Gastro-oesophageal reflux is identified in approximately 70% of symptomatic infants and children with CRF.
Complex gastrointestinal motility disorders, including delayed gastric emptying, are observed in symptomatic pediatric CRF patients.
Elevated serum levels of polypeptide hormones regulating gastrointestinal motility and appetite are common in CRF and normalize post-transplantation.

Conclusions:

Humoral alterations and gastrointestinal dysmotility significantly contribute to anorexia, nausea, and vomiting in pediatric CRF.
Effective management of vomiting and feeding problems in pediatric CRF necessitates specific pharmacological and nutritional strategies.
Further research into the complex interplay of factors affecting GI function in pediatric CRF is warranted.