Evaluation of gastric emptying in patients with chronic renal failure on continuous ambulatory peritoneal dialysis using 99m Tc-solid meal
2004
BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an alternative
to the hemodialysis mode of terminal renal failure treatment. Nutritional status
impairment is common among patients with end-stage renal disease, and its laboratory
surrogates predict increased morbidity and mortality risk in patients on chronic
haemodialysis or peritoneal dialyses. The aetiology of malnutrition is multifactorial
and delayed gastric emptying is also considered to be a significant factor. The
aim of this study was to estimate the direct influence of indwelled dialysate
in the peritoneal cavity on gastric emptying in patients treated with CAPD. MATERIAL AND METHODS: the study group included 20 patients (9 males, 11
females) aged 50,1 ± 11 years (range: 39–75 years) with chronic renal failure
treated with CAPD for 18.4 ± 14.7 months. All patients were non-diabetic and had
no other than chronic uraemia co-morbidity known to influence autonomic nervous
system function and gastric motility. The control group included 15 healthy volunteers
matched by age, sex and body weight. Dialysis adequacy parameters were calculated
based on 24-hour urine and dialysate collections. Gastric emptying was estimated
with dynamic abdominal scintigraphy. We compared the results of gastric emptying
tests performed in dialysed patients with and without dialysate liquid in the
peritoneal cavity and related the values to those of the control subjects. RESULTS: In the study group, weekly values of dialysis parameters were
within the ranges considered satisfactory in terms of uraemia control. All parameters
of gastric emptying were significantly delayed and prolonged in terminal renal
failure patients, but the results have shown no significant differences between
those with and without indwelling dialysate. CONCLUSIONS: Based on the results we conclude that gastric emptying in
subjects with chronic renal failure treated with CAPD is markedly delayed compared
to healthy subjects. There was no significant effect of indwelling dialysate in
the peritoneal cavity on gastric emptying rates found, based on the observation
that its removal was not associated with any noticeable improvement of gastric
emptying. The data strongly contraindicate the theory of peritoneal dialysate
volume being the cause of this reversible disorder and indicate that the role
of other possible factors leading to the development of gastropathy in those patients
should be investigated.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
0
References
2
Citations
NaN
KQI