gastrins and Kidney-Diseases

The application of radioimmunoassay of insulin, C-peptide, gastrin, glucagon, vasoactive intestinal polypeptides (VIP), somatostatin, human pancreatic polypeptides (hPP), substance P and neurotensin to detect endocrine tumors of the pancreas and other organ systems is undoubtedly important in the clinical management of patients suspected of having tumors that secrete these hormones. Radioimmunoassays of the above gut peptides have certain degrees of specificity and sensitivity; however, there are several factors that need to be considered in the interpretation of results since heterogeneity of molecular forms does occur and the varied radioimmunoassay techniques use different antibodies that may yield different results. It is, therefore, important that each laboratory establish its own normal values, determine the molecular species that each assay is detecting, and also determine the false positivity of the methodology. The same endocrine tumor may contain and secrete several detectable peptides, but the syndrome may relate to only one peptide. Although the simultaneous measurement of multiple peptides in patients with benign gastrointestinal disease has yielded information that contributes to our understanding of the complexities of gut neuroendocrine interaction, the pathophysiological role of gut peptides and their clinical relevance need further evaluation.

Topics: Animals; Diagnosis, Differential; Digestion; Food; Gastrins; Gastrointestinal Diseases; Gastrointestinal Hormones; Humans; Kidney Diseases; Pancreatic Neoplasms; Pancreatic Polypeptide; Radioimmunoassay; Vagus Nerve; Vasoactive Intestinal Peptide; Vipoma; Zollinger-Ellison Syndrome

Topics: Acute Kidney Injury; Animals; Dogs; Gastric Mucosa; Gastrins; Graft Rejection; Humans; Insulin; Kidney; Kidney Diseases; Kidney Failure, Chronic; Kidney Transplantation; Metabolic Clearance Rate; Proteinuria; Rats; Zollinger-Ellison Syndrome

The Verner-Morrison Syndrome is a clinically defined entity caused by an islet cell tumor of the pancreas. More than 60 cases have been described so long. The syndrome is characterized by diarrhea, hypokalemia and hypochlorhydria. In addition to a diabetic disposition, raised calcium levels and skin alterations may be present. The diagnosis is a clinical one. A pancreatic tumor should be searched for and removed. Morphologically a benign and a maligne islet cell tumor or a diffuse hyperplasia of the islets of Langerhans can be found. Until now identification of the tumor cells has not been possible. There seems no doubt that the tumor cells produce a peptide hormone. Secretin, gastric inhibitory polypeptide, vasoactive intestinal polypeptide and combinations of hormones are discussed. The results are contradictory. Theories concerning the formal and causal pathogenesis are only incomplete and unproved up to now.

Topics: Achlorhydria; Adenoma, Islet Cell; Adolescent; Adult; Aged; Diarrhea; Female; Gastrins; Glucagon; Humans; Hypokalemia; Kidney Diseases; Male; Middle Aged; Pancreatic Neoplasms; Peptides; Pregnancy; Secretin; Syndrome

Topics: Acute Kidney Injury; Gastric Juice; Gastric Mucosa; Gastrins; Humans; Kidney; Kidney Diseases; Kidney Failure, Chronic; Renal Dialysis; Uremia

Topics: Achlorhydria; Acute Kidney Injury; Adenoma, Islet Cell; Adult; Cholecystokinin; Dehydration; Diarrhea; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Hypercalcemia; Hypokalemia; Kidney Diseases; Male; Pancreatic Neoplasms; Protein Precursors; Secretin; Syndrome; Zollinger-Ellison Syndrome

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Chlorpromazine; Circadian Rhythm; Cold Temperature; Diabetes Mellitus; Diet; Female; Gastric Juice; Gastrins; Humans; Kidney Diseases; Male; Middle Aged; Stomach Ulcer; Stress, Physiological

Gastric dilatation (GD) has been observed in Tac:(SW)fBR surveillance mice, with mean age of 10 months, that are exposed to high levels of environmental antigens during routine exposure to dirty bedding. The aim of the study reported here was to determine whether GD was associated with other systemic conditions affecting mice. Three groups of nine animals including-surveillance mice not exposed to dirty bedding (control), surveillance mice with out GD (NGD), and surveillance mice with GD (group GD)-had mean stomach weight with ingesta of 0.5 +/- 0.02 g, 1.09 +/- 0.07 g (P < 0.0001), and 2.54 +/- 0.4 g (P < 0.0001), respectively. Mean serum creatinine concentration was significantly higher in GD (1.6 +/- 0.25 mg/dl), compared with NGD (0.17 +/- 0.22 mg/dl, P < 0.0001) and control (0.2 +/- 0.16 mg/ dl, P < 0.0001) mice. In addition, lesions consistent with severe chronic nephropathy and mild gastritis were common in GD, compared with NGD and control mice. Finally, serum amidated gastrin concentration was significantly high in GD (179.37 +/- 53.86 pM, P < 0.03) and NGD (264.89 +/- 115.89 pM, P < 0.009), compared with control (60.77 +/- 8.39 pM) mice. Gastric dilatation syndrome is associated with chronic nephropathy, hypergastrinemia, and gastritis in surveillance mice exposed to high levels of environmental antigens.

Topics: Animals; Antigens; Dilatation, Pathologic; Environmental Monitoring; Gastrins; Gastritis; Kidney Diseases; Mice; Stomach; Syndrome

Topics: Chronic Disease; Enterochromaffin Cells; Gastric Mucosa; Gastrins; Glomerulonephritis; Humans; Kidney Diseases; Nephrotic Syndrome; Pyelonephritis; Renal Dialysis

In 46 kidney patients aged from 30 to 71 years, after an overnight fast, serum levels of trypsin (TLI), gastrin (Gas), parathromone (PTH), calcium (Ca), magnesium (Mg), phosphate (iP), amylase, were evaluated. Ten patients had a normal renal function; in 18 patients glomerular filtration rate (GFR) ranged from 5 to 70 ml/m'; 18 patients with GFR below 2 ml/m' were treated with 4 hours hemodialysis. In dialysed patients TLI was evaluated before and after dialysis. In patients with FGR ranging from 120 to 5 ml/m' a significant inverse correlation (p < 0.001) appeared between TLI and GFR values. In the same group a significant direct correlation (p < 0.001) was found between PTH and TLI. The study showed also a significant direct correlation between amylase and TLI (p < 0.001); likewise TLI, amylase was inversely correlated to GFR (p < 0.01) and directly to PTH (p < 0.001). No correlation was found between TLI and Gas, Ca, Mg, iP. A significant inverse correlation was found between PTH and GFR (p < 0.01). Because serum level of PTH, amylase and TLI were related to GFR values, we calculated partial correlation between these parameters. The partial correlation coefficients of the relation between PTH and TLI, PTH amylase, holding GFR constant, were higly significant (p < 0.001). On the contrary, holding a constant PTH, the correlations between pancreatic enzymes and GFR were not confirmed. Pre-dialysis TLI levels were significantly higher than post-dialysis (p < 0.05).. 1) TLI and amylase have the same behaviour in renal failure; 2) the levels of both enzymes are high in renal insufficiency; their values seem to be correlated to secondary byperparathyroidism.

Topics: Adult; Aged; Amylases; Calcium; Female; Gastrins; Glomerular Filtration Rate; Humans; Hyperparathyroidism, Secondary; Kidney Diseases; Magnesium; Male; Middle Aged; Parathyroid Hormone; Phosphates; Renal Dialysis; Trypsin

Serum gastrin levels have been studied in 70 patients with chronically reduced glomerular filtration rate (GFR) as estimated by 51Cr-EDTA clearance, creatinine, and beta2-microglobulin values. A strong dependence upon GFR was found, although the correlation between gastrin levels and GFR was not as high as that between beta2-microglobulin and GFR, indicating the existence of extrarenal factors regulating the levels of circulating gastrin. In a separate group of 31 patients on maintenance dialysis the mean gastrin level was 65.9 pmol/l--that is, a fourfold increase compared to healthy subjects. Three of the uraemic patients had pronounced rises in serum gastrin in the range 800-1800 pmol/l. Finally, the influence of acute alterations of kidney function on serum gastrin was studied in 11 patients undergoing renal transplantation. In addition to a GFR dependence the results indicate the existence of feedback mechanisms in gastrin homeostasis. Although the clinical importance of the increased gastrin levels in renal failure is unknown, hypergastrinaemia occurs with sufficient frequency to be involved in upper gastrointestinal complications of uraemic patients.

Topics: Adolescent; Adult; Aged; Antigens; beta 2-Microglobulin; Creatinine; Female; Gastrins; Glomerular Filtration Rate; Humans; Kidney; Kidney Diseases; Kidney Transplantation; Male; Middle Aged; Renal Dialysis; Uremia

The AA., on the basis of their recent studies, offer a new hypothesis on the role of calcitonin, as a regulator of phosphorus metabolism. In addition the AA. confirm the clear interrelationship between calcitonin and other hormones as gastrin and autonomous nervous system.

Topics: Autonomic Nervous System; Calcitonin; Calcium; Ethanol; Gastrins; Humans; Hypocalcemia; Insulin; Insulin Secretion; Kidney Diseases; Phosphorus; Propranolol

Fasting blood gastrin level among various clinical entities was measured by means of radioimmunoassay. Hypergastrinemia of various degrees was found in some cases of chronic renal failure. During angiography arteriovenous difference of gastrin level was investigated in the kidney in 22 patients without renal diseases. The high rate of gastrin removal from the blood circulation by the kidney was also confirmed in the synthetic human gastrin 1-17 (SHG 1-17) infusion experiment in dogs. In this study, hypergastrinemia seen in renal diseases was thought to be caused partly by impaired gastrin metabolism in the kidney.

Topics: Animals; Dogs; Female; Gastrins; Humans; Kidney; Kidney Diseases; Male

Topics: Animals; Biliary Tract Diseases; Dogs; Gastrins; Humans; Kidney Diseases; Liver Diseases

Our experience with a commercially available kit for the measurement of serum gastrin has been reported. Significant non-specific interference was noted by the addition of serum contents in the assay which lead to erroneous results. Use of gastrin free serum as a diluent in the standard curve was found to improve the mean recovery of added gastrin. With this modification the procedure was evaluated for its clinical application. In 30 normal subjects, the fasting mean gastrin level was 78.7 plus or minus 31.9 (S.D.) pg/ml; in 18 of these individuals the postprandial mean level was 118.3 plus or minus 26.7 (S.D.) pg/ml. In 15 patients with pernicious anemia the mean level was 912 plus or minus 779 pg/ml; and in 4 patients with Zollinger-Ellison (ZE) syndrome the mean gastrin level was 1950 plus or minus 379 (S.D.) pg/ml. A significant rise in gastrin level was noted in patients with kidney failure during and after dialysis (p smaller than 0.05).

Topics: Anemia, Pernicious; Blood Proteins; Gastrins; Humans; Iodine Radioisotopes; Kidney Diseases; Radioimmunoassay; Zollinger-Ellison Syndrome

Topics: Acromegaly; Dietary Proteins; Gastrectomy; Gastrins; Gastrointestinal Diseases; Humans; Kidney Diseases; Liver Cirrhosis; Peptic Ulcer; Radioimmunoassay; Stomach Neoplasms

Topics: Gastrins; Gastrointestinal Diseases; Humans; Kidney Diseases; Liver Diseases; Pancreatic Diseases; Stomach Diseases

Topics: Anemia, Pernicious; Animals; Cattle; Diabetes Mellitus; Gastric Juice; Gastrins; Humans; Kidney Diseases; Rabbits; Radioimmunoassay

Topics: Acute Kidney Injury; Adenoma, Islet Cell; Dehydration; Diarrhea; Female; Gastrins; Humans; Hyperglycemia; Hyperinsulinism; Hypokalemia; Insulin; Insulin Secretion; Kidney Diseases; Middle Aged; Multiple Endocrine Neoplasia; Pancreatic Neoplasms; Paraneoplastic Endocrine Syndromes; Zollinger-Ellison Syndrome