Gastrin processing and secretion in patients with end-stage renal failure

Area of Science:

• Endocrinology
• Nephrology
• Gastroenterology

Background:

• Elevated gastrin levels are observed in end-stage renal failure (ESRF) patients.
• The specific forms of gastrin elevated and secretory profiles post-stimulation in ESRF remain unclear.
• Helicobacter pylori (HP) infection influences gastrin secretion and needs consideration.

Purpose of the Study:

• To quantify all processed and partially processed forms of circulating gastrin in ESRF patients before and after meal stimulation.
• To investigate the impact of HP infection on gastrin levels and secretory profiles in ESRF.
• To assess the role of somatostatin in regulating gastrin secretion in ESRF.

Main Methods:

• Measurement of fasting and post-meal plasma gastrin-amide, gastrin-Gly, and total gastrin in ESRF patients and controls.
• Determination of HP status in all study participants.
• Measurement of fasting plasma somatostatin levels.

Main Results:

• Fasting gastrin-amide, gastrin-Gly, and total gastrin were significantly higher in ESRF patients, especially those with HP infection.
• The proportion of nonamidated gastrin products was significantly higher in ESRF patients.
• Meal-stimulated gastrin response was potentiated in ESRF/HP+ patients, and somatostatin levels were lower in ESRF patients.

Conclusions:

• Hypergastrinemia in ESRF is underestimated when only amidated forms are measured.
• HP infection partially explains the potentiated gastrin meal response in ESRF.
• Reduced somatostatin and decreased gastrin metabolism contribute to increased circulating gastrin in ESRF, potentially explaining gastrointestinal hypertrophy.