Upper Gastrointestinal Findings in Chronic Renal Failure

Abstract

Twenty-nine patients with chronic renal failure were examined both during the predialytic stage and after active treatment (dialysis, transplantation) for upper GI diseases. They underwent a gastric dose-response secretion test, gastroduodenoscopy, radiologic upper GI series, and fasting serum gastrin determination. Upper GI diseases increased in the active treatment stage. At the time of examination, patients with these diseases had a positive ulcer history, duodenitis, duodenogastric reflux, and blood group O more often in the predialytic stage. Their stimulation sensitivity to pentagastrin and their acid secretion capacity were greater, and they were less achlorhydric. Their fasting serum gastrin level was also lower. They had less endoscopically discovered gastritis, but microscopically, with regard to gastritis, they did not differ from those who did not develop upper GI complications. In conclusion, in chronic renal failure upper GI findings increase after the active treatment. Secretion tests and endoscopy performed before active treatment give an indication of those who will develop upper GI complications during active treatment.

Gastrointestinal Evaluation in Chronic Kidney Diseases

“…Ala Kaila et al [4] studied 29 patients with CKD both during predialytic stage and after active treatment for upper GI disease. Upper GI diseases increased in active treatment stage.…”

“…Several factors, such as the cause of terminal uraemia, immunosuppressive medication and infections, can predispose kidney transplantation patients to the development of GI problems. Chronic hemodialysis (HD) patients continue to suffer from various symptoms referable to the upper GI tract [4]. Gastric pathologic changes are common in HD patients [5].…”

Pharmacokinetics and pharmacodynamics of roxatidine in patients with renal insufficiency.

“…These symptoms may be caused by gastric and duodenal ulcers, erosions or gastritis [1][2][3]. Histamine H2-receptor antagonists are drugs of first choice in the management of acid related diseases [4].…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…Peptic ulcer disease (PUD) was once such a frequent (18-40%) and potentially lethal posttransplant complication that pretransplant screening and even surgery were often recommended (Table 54) (472)(473)(474)(475)(476)(477)(478)(479)(480)(481)(482)(483)(484)(485)(486). With the increasing use of prophylactic antacids, the incidence of symptomatic PUD has declined.…”