Fernstrom A, Hellstrom A, Gryback P, Jacobsson H, Hylander B
Gastric emptying in patients with ESRD, CAPD or hemodialysis
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S15 1997
Although delayed gastric emptying is a common feature in diabetics,
its role in non-diabetic ESRD patients is perhaps less well
established, although it has been described. Fernstrom and colleagues
studied gastric emptying by scanning the abdomen over time after
administering a radionuclide-tagged egg omelette in 27 ESRD patients,
17 of them on dialysis, and in 24 controls. The half-emptying time
(T50), % retention at 2 hours (%Ret 120), and gastric emptying rate
(GER) were measured.
The rate of gastric emptying seemed to be slower in CAPD patients than
in controls or in HD patients, but the number of patients in the
various subgroups was quite small (7 CAPD and 5 HD, for example).
Comment: This is a small study, and it is unclear how the data
add to the existing literature. Brown-Cartwright
(Gastroenterology, 95:49-41, 1988) found that gastric emptying
was normal in CAPD patients studied when dry, but impaired when full.
On the other hand, Kao et al found gastric emptying time to be
impaired in 88% of 40 CRF patients, only half of whom were on
dialysis. Abdominal symptoms did not predict abnormal emptying times
in Kao's study (Nucl Med Commun 17:164-7, 1966). At the present
time, there are no clear indications for studying gastric emptying in
anorectic non-diabetic dialysis patients in the absence of suspicion
of amyloidosis.
(John T. Daugirdas, M.D., University of Illinois at Chicago)
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17th Annual CAPD Conference
CRF by organ system :
GI/Liver, Hepatitis