Gastric dysfunction in dialysed patients with chronic renal failure.

BACKGROUND: Gastric motor functions are disturbed in patients with chronic renal failure (CRF). The aim of this study was to find the relationship between GI symptoms, gastric myoelectrical activity and regulatory peptides (gastrin, motilin, VIP, CCK) in patients with CRF treated with hemodialyses (HD) and peritoneal dialyses (CAPD). METHODS: Gastric myoelectric activity was evaluated with cutaneously recorded electrogastrographs (EGGs) measurement in: group A: 23 pts with CRF treated with CAPD, group B: 21 pts treated with HD and group C: 48 matched healthy controls. GI symptoms severity was quantified with specially designed questionnaire. The laboratory evaluation of plasma parameters, such as: gastrin, motilin, VIP and CCK was performed. RESULTS: The patients with CRF treated with CAPD and HD showed a significantly lower percentage of normal 2-4 cpm wave's rhythm in both fasting (65.3 +/- 29.3% vs 43.5 +/- 35.9% vs 86.4 +/- 10.2%) and fed conditions (72.7 +/- 34.2% vs 69.5 +/- 22.1% vs 89.3 +/- 9.5%) in comparison to controls. In the fasting state, none of the healthy controls had an abnormal EGG, whereas the 27 patients with CRF (61.3%) had an abnormal EGG. In the fed state the 18 patients with CRF (40.9%). No significant increase of the dominant power (PDP) after meal in CRF patients was observed. The plasma concentrations of gastrin, CCK were increased in fasted and fed CRF patients, whereas VIP and motilin only in fed state. CONCLUSIONS: The patients with CRF showed impaired gastric myoelectrical activity in response to food and high levels of GI hormones. Gastric dysmotility and high peptides appears to be partially responsible for GI symptoms.