gastrins and Uremia

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

Objective To observe the effect of Muxiang Shunqi Pill (MSP) on digestive disorders of prephase uremia patients, and to study its underlying mechanism. Methods A total of 40 prephase uremia patients with gastrointestinal symptoms were randomly and equally assigned to the MSP group and the Mosapride group. Besides, 20 subjects with normal physical examinations were recruited as the control. Patients in the MSP group took MSP, 6 g each time, three times per day, taken 30 min after dinner. Those in the Mosaprido group took Mosapride Tablet (MT) , 5 mg each time, three times per day, taken 30 min before diner. The therapeutic course for all was 4 weeks. The clinical curative effect was observed. Electrogastrogram, serum levels of gastrin (GAS) and motilin (MTL) , safety and recurrence rate were evaluated. Results The total effective rate was 90% (18/20) and the recurrence rate was 15% (320) in the MSP group, higher than those of the Mosapride group [60%(12/20) , X² =4. 80, P =0. 025; 45% (9/20) , X² =4. 29, P =0. 025]. Compared with before treatment in the same group, the percentage of normal rhythm increased, the bradygastria rate was lowered, serum levels of GAS and MTL increased in the two groups after treatment (P <0. 05, P <0. 01). Compared with the Mosapride group, the bradygastria rate decreased more obviously, serum levels of GAS and MTL were increased more in the MSP group (P <0. 05, P <0. 01). Conclusion MSP could effectively improve digestive disorders of prephase uremia patients, which might be achieved through promoting gastrointestinal motility and regulating ser- um levels of gastrointestinal hormones.

Topics: Digestive System Diseases; Gastrins; Gastrointestinal Motility; Humans; Medicine, Chinese Traditional; Motilin; Uremia

This study was conducted to evaluate gastric acid secretion in acute renal failure, highlighting the roles of renal mass and gastrin hormone. Acute uremic rats were divided into bilateral nephrectomized and bilateral ureteric obstruction groups. Gastric juice was collected for 2 h and analyzed for volume, free acidity, total acidity, and total acid output. Plasma levels of creatinine, urea, and gastrin were also determined. Bilateral nephrectomized and bilateral ureteric obstruction groups showed a significant increase in levels of free acidity, total acidity, and plasma gastrin. Compared with the ureteric obstruction group, nephrectomized rats showed a significant increase in gastric juice volume, total acid output, and plasma gastrin levels. Following pentagastrin stimulation, gastric juice volume, total acid output, free acidity, and total acidity were increased in the bilateral nephrectomy and ureteric obstruction groups compared with the respective control groups. The free and total acidity and total acid output also increased compared with the respective non-stimulated groups. Plasma creatinine and urea levels were significantly positively correlated with plasma gastrin, free acidity, and total acidity. Creatinine was positively correlated with total acid output, and gastrin was positively correlated with total acidity. In conclusion, acute renal failure promotes gastric acid hypersecretion that could potentially be attributed to high levels of gastrin hormone and uremic state per se.

Topics: Acute Kidney Injury; Animals; Creatinine; Disease Models, Animal; Gastric Acid; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastrins; Male; Nephrectomy; Pentagastrin; Rats; Rats, Wistar; Time Factors; Urea; Uremia; Ureteral Obstruction

From March 1992 to July 1992, 30 uremic patients (15 dialysed, 15 non-dialysed) and 15 non-uremic patients who had dyspeptic complaints were compared in terms of gastric and duodenal diseases. Gastritis and duodenitis graded as I, II and III were not found different in three groups (p > 0.05). Although the incidence of peptic ulcer disease is very high in both groups of uremic patients in comparison with the controls, there was no significant difference between two uremic groups (p > 0.05). Also the prevalence of gastritis determined histologically was not different in dialysed and non-dialysed uremic patients (p > 0.05). The incidence of the histologically proven gastritis was found higher in uremic patients than in non-uremic patients (p < 0.05). But, there were no significant differences among the three groups with regard to the rate of histologically proved duodenitis (p > 0.05). Gastrin levels, urea positivity, the incidence of gastritis and duodenitis and peptic ulcers did not differ in both uremic groups. However, these values were found significantly high in the uremic patients when compared to non-uremics. These findings showed serum gastrin levels, H.-pylori-infection, gastritis and duodenal disease in the uremic patients to be higher than those of the control group. Moreover, no effect of hemodialysis treatment on these results was observed.

Topics: Adult; Aged; Aged, 80 and over; Endoscopy, Digestive System; Female; Gastric Mucosa; Gastrins; Gastrointestinal Diseases; Humans; Incidence; Intestinal Mucosa; Kidney Failure, Chronic; Male; Middle Aged; Prevalence; Renal Dialysis; Retrospective Studies; Uremia

It has been shown previously that antisecretory response of famotidine is altered in patients with renal failure. To evaluate the underlying mechanism(s) of this clinical observation we obtained biopsy specimens of fundic mucosa from 3 groups of patients with variable renal function (group 1 normal renal function (n = 16); group 2 chronic renal failure (n = 16), CLCR > or = 5 < 90 ml/min; group 3 hemodialysis therapy (n = 16)) (matched for age, sex, and Helicobacter pylori (Hp) status. In the homogenized samples adenylate cyclase (AC) activity was assessed and the influence of uremia on this second messenger system involved in gastric acid secretion was tested. AC activity was measured as the formation of cAMP, which was determined by RIA. The mean basal AC activity was 150 in group 1, 190 in group 2, and 120 pmol cAMP/mg protein/20 min in group 3. There was a dose-dependent stimulation by histamine (1 microM-1 mM). Emax of cAMP formation ranged between 230 and 403 pmol cAMP/mg protein/20 min and EC50 between 5.9 and 20.1 microM histamine, dependent on Hp status. Histamine-stimulated AC activation was reduced to about 50% by 0.1 mM famotidine. The sensitivity of AC to histamine seems to decrease in patients undergoing hemodialysis. Similarly, the colonization with Hp may result in decreased maximal response of the AC system towards histamine.

Topics: Adenylyl Cyclases; Anti-Ulcer Agents; Cyclic AMP; Famotidine; Female; Gastric Mucosa; Gastrins; Helicobacter Infections; Helicobacter pylori; Humans; Kidney Failure, Chronic; Male; Middle Aged; Sodium Fluoride; Uremia

In a rat model of chronic renal failure, we recently reported that hypergastrinemia was associated with increased stomach weight and parietal cell and enterochromaffin-like (ECL) cell density. In this study, the role of gastrin in mediating trophic effects of uremia on the gastric mucosa was examined by chronic immunoneutralization of endogenous gastrin in the sub-total nephrectomy uremic rat model. Three weeks after surgery, the rats were uremic (azotemic and hypertensive). Uremic rats had a significant increase in corpus mucosal height (17%), parietal cell density (14%), ECL cell density (27%), and basal gastric mucosal blood flow (63%). These effects were specifically inhibited by chronic administration of gastrin-specific monoclonal antibody (5 mg ip every other day) in the 3-wk postoperative period. Uremic rats also had an increase in stomach weight (23%), corpus mucosal area (8%), arterial blood pressure, and serum creatinine and a decrease in body weight. Gastrin immunoneutralization did not alter these effects. The findings suggest that elevated levels of endogenous circulating gastrin in uremic rats mediate, in part, the trophic response observed in the gastric mucosa.

Topics: Animals; Antibodies; Cell Division; Gastric Acid; Gastric Mucosa; Gastrins; Male; Rats; Rats, Sprague-Dawley; Regional Blood Flow; Stomach; Uremia

The prevalence of peptic ulcer in cirrhotic patients is similar to that reported for the general population. Although gastric acid outputs ar normal or lower in cirrhotic subjects compared with non-cirrhotics, the frequency of non-response to histamine H2-receptor antagonists is higher. Peptic ulcer disease in the cirrhotic seems to pursue a more virulent course compared with that in the non-cirrhotic subject. Peptic ulcer prevalences in patients dying of uraemia or in uraemic patients on maintenance dialysis treatment are comparable with those in the general population. However, the frequency of peptic ulcer, especially complicated ulcer, is increased following renal transplantation. Ulcer complications in this context are associated with a high mortality rate. Pre-transplant risk factors for subsequent development of peptic ulcer remain to be identified and the value of histamine H2-receptor antagonists in prophylaxis is as yet unproven.

Topics: Duodenitis; Gastric Acid; Gastric Mucosa; Gastrins; Gastritis; Humans; Kidney Failure, Chronic; Liver Cirrhosis; Peptic Ulcer; Peptic Ulcer Hemorrhage; Uremia

Hemodialysis patients are frequently affected by peptic disease, and in many cases they have high serum levels of gastrin. The aim of this study was to evaluate the effects of omeprazole, an inhibitor of gastric parietal cells hydrogen pump, on peptic disease and gastric secretion of 16 selected dialysis patients. H2-receptors blocking drugs or gastric acidity buffers were withdrawn for 2 weeks, then omeprazole was administered for 4 weeks at a daily dosage of 20 mg. Before and after the omeprazole therapy, registration of subjective peptic symptoms, baseline serum gastrin dosage and endoscopy of upper digestive tract were performed. Before starting omeprazole, the serum gastrin value was 515 +/- 180 pg/l, all the patients complained of peptic symptoms, and endoscopy showed: 8 cases of duodenal ulcer, 3 cases of pyloric ulcer and 5 cases of antral erosive gastritis. At the end of the omeprazole treatment period, a slight but statistically not significant increase of serum gastrin level (537 +/- 198 pg/l) was observed. Twelve patients reported the total disappearance of symptoms of peptic disease, 3 patients a partial reduction, and 1 patient had no improvement. Control endoscopy showed the healing (white scar) of all the ulcers, and the disappearance of all the erosive lesions. In conclusion, our results show that a 20 mg/day omeprazole short-term therapy can be given safely to uremic patients undergoing hemodialysis and is effective for a quick healing of active peptic lesions.

Topics: Adult; Drug Administration Schedule; Female; Gastrins; Humans; Male; Middle Aged; Omeprazole; Peptic Ulcer; Renal Dialysis; Time Factors; Uremia

In this study we analyzed by gas chromatographic headspace analysis the composition and concentration of gastrin-stimulatory volatile aliphatic amines in the gastric juice of healthy subjects and acute renal failure patients. We demonstrated that although these aliphatic amines are present in the gastric juice of normal subjects in trace amounts, they accumulate in the gastric juice of uremic subjects. This 30-40-fold elevation in gastric juice amine concentration agreed favorably with the 40-50-fold augmentation in serum gastrin levels in acute renal failure, with a significant association (r = 0.87) existing between these two parameters. It was also determined that a 2-hr hemodialysis procedure resulted in a modest nonparallel decline in both gastric amine and serum gastrin levels. These results support the hypothesis that the accumulation of volatile aliphatic amines in the gastric juice of uremic individuals may induce an activation of the antral G cells, resulting in hypergastrinemia.

Topics: Acute Kidney Injury; Amines; Chromatography, Gas; Gastric Juice; Gastrins; Humans; Renal Dialysis; Uremia

Topics: Gastric Acid; Gastrins; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Humans; Telangiectasis; Uremia

To evaluate the effect of renal transplantation on the frequent gastric hypoacidity encountered among uraemic patients, 84 patients (19 with chronic renal failure receiving dietary treatment, 29 receiving regular dialysis treatment, and 36 with a well-functioning renal transplant) were studied for their gastric acid secretory capacity. The mean duration of preoperative dialysis treatment of the dialysed patients was 13.7 months, and the mean length of postoperative follow-up study of the transplant patients was 10.1 months. The mean gastric acid secretory capacity of all three subgroups of renal patients was similar, and all these means fell within the reported reference interval of healthy controls. Gastric hypoacidity was observed in 26% of the non-dialysed and in 17% of the dialysed patients but also in 28% of the patients with a well-functioning renal graft. Thus uraemia seems to result in gastric hypoacidity, which tends to persist for over 10 months after normalization of renal function through transplantation.

Topics: Adult; Female; Gastric Acid; Gastrins; Humans; Kidney Transplantation; Male; Middle Aged; Pentagastrin; Postoperative Complications; Renal Dialysis; Uremia

To gain further understanding of the peptic complications encountered in renal transplant surgery, 84 patients (19 with chronic renal failure on dietary treatment, 29 on regular dialysis treatment, 36 with a well-functioning renal transplant) were studied with regard to gastric acid secretion capacity and serum concentrations of gastrin and group I pepsinogens (PG I). The mean duration of preoperative dialysis treatment of the dialysed patients was 13.7 months. The mean length of postoperative follow-up of the transplant patients was 10.1 months. There was no significant difference between the mean gastric acid secretion of the three groups of patients. All the means were within the reported reference interval for healthy controls. However, 26% of the non-dialysed, 17% of the dialysed and 28% of the transplant patients had gastric hyposecretion. The mean serum concentration of gastrin was elevated in all patient groups and unaffected by normalization of renal function through transplantation, unlike PG I, which was normalized by the procedure. Thus, in the present era of treatment of chronic renal failure with a relatively short period of dialysis treatment, the frequent gastric hypoacidity, which is known to be peculiar to non-dialysed uraemic patients, seems also to characterize dialysis and transplant patients.

Topics: Adult; Female; Gastric Acid; Gastrins; Humans; Kidney Transplantation; Male; Middle Aged; Pepsinogens; Renal Dialysis; Uremia

The authors analyzed 380 autopsies for chronic glomerulo- and pyelonephritis and studied the clinical and functional features of gastric pathology in 240 patients with the same disease entities. The hypotheses are suggested about a 3-stage successive formation of uremic gastropathy. The importance of hypergastrinemia as one of the pathogenetic factors, as a vicarious organ as regards nitrogenous products at early stages of chronic renal insufficiency is discussed.

Topics: Gastric Mucosa; Gastrins; Gastritis; Gastritis, Atrophic; Humans; Hydrogen-Ion Concentration; Urea; Uremia

An endoscopic and biopsy study of the upper gastrointestinal tract in 102 patients receiving regular dialysis treatment (RDT) for chronic renal failure, showed prominent hypertrophic folds and a peculiar pale-grey or pale-pink colour of the gastric mucosa in most cases. Gastric erosions occurred in 11 cases and gastric ulcer in two. Duodenal erosions were found in 13 cases, eight of which were associated with hyperplasia of Brunner's glands. Duodenal ulcer occurred in one case. The histological findings were compared with those in 100 subjects with an endoscopically normal gastro-duodenal tract. In most cases of the RDT group the fundal area was enlarged at the expense of the antrum, fundal glands and/or isolated parietal cells often spreading within the duodenal mucosa. In most cases the duodenal bulb showed hyperplasia of Brunner's glands and heterotopic gastric surface epithelium. The frequency of the mucosal changes differs significantly in the two groups of subjects. Gastric hyperplastic changes in RDT are probably due to the trophic action of hypergastrinemia which is of common occurrence in such a condition, and can account for gastric acid hypersecretion. Acid hypersecretion, in turn, can account for the duodenal changes and gastroduodenal lesions.

Topics: Adolescent; Adult; Aged; Antacids; Duodenum; Female; Gastric Mucosa; Gastrins; Humans; Intestinal Mucosa; Male; Middle Aged; Renal Dialysis; Uremia

Topics: Adrenocorticotropic Hormone; Aldosterone; Angiotensins; Carbohydrate Metabolism; Catecholamines; Endocrine System Diseases; Erythropoietin; Female; Gastrins; Gonadal Steroid Hormones; Humans; Hydrocortisone; Kidney Failure, Chronic; Male; Renal Dialysis; Renin; Thyroid Gland; Uremia; Vasopressins

Topics: Adult; Chronic Disease; Female; Gastrins; Humans; Male; Middle Aged; Pepsinogens; Peptic Ulcer; Renal Dialysis; Uremia

Topics: Adult; Chronic Disease; Dyspepsia; Female; Gastrins; Gastritis; Gastritis, Atrophic; Humans; Male; Middle Aged; Renal Dialysis; Uremia

Plasma levels of somatostatin-like immunoreactivity (SLI) and gastrin were determined by radioimmunoassay in patients with varying degrees of renal dysfunction. The plasma SLI was not increased in patients with end-stage renal failure as compared to healthy controls. In patients with varying degrees of renal insufficiency no significant correlation was found between the plasma SLI and kidney function as estimated by the 51Cr-EDTA-clearance rate. In uraemic patients a significant inverse correlation was found between plasma SLI and plasma gastrin.

Topics: Adolescent; Adult; Aged; Child; Female; Gastrins; Humans; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Somatostatin; Uremia

Basal circulating levels of gastrin, somatostatin, and pancreatic polypeptide were measured in 30 chronic haemodialysis patients. Five patients had considerably raised serum gastrin (greater than 400 pmol/1) and also gastric achlorhydria while 75% of the patients who had normal (less than 55 pmol/1) or moderately increased (less than 400 pmol/1) serum gastrin had raised maximal acid outputs. Patients with serum gastrin greater than 400 pmol/1 had significantly lower plasma concentrations of somatostatin compared with both healthy individuals and uaremic patients with normal gastrin levels. Raised serum concentrations of pancreatic polypeptide were observed in the majority of the patients but no correlation was found between this peptide and gastric acid secretion or circulating levels of gastrin and somatostatin, respectively. Prolonged circulation time for gastrin and pancreatic polypeptide was demonstrated after food stimulation. Prolonged gastrin stimulation of the parietal cell mass may lead to work hypertrophy and gastric acid hypersecretion. Whether long-standing over-stimulation by gastrin also may induce atrophy of the cells remains to be studied.

Topics: Adolescent; Adult; Female; Gastric Juice; Gastrins; Humans; Male; Middle Aged; Pancreatic Polypeptide; Somatostatin; Uremia

Topics: Adult; Aged; Cell Count; Duodenal Ulcer; Female; Fluorescent Antibody Technique; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Histocytochemistry; Humans; Male; Middle Aged; Peptic Ulcer; Pyloric Antrum; Staining and Labeling; Stomach; Stomach Neoplasms; Stomach Ulcer; Uremia

The distribution and numbers of G cells and of parietal cells were related to the distribution and severity of histopathological alterations (inflammatory cell infiltration, atrophy and intestinal metaplasia) in corresponding mucosal tissue blocks from resected stomachs (12 patients with gastric ulcer, 11 with duodenal ulcer, and 14 with duodenal ulcer and uremia). In all patients the histopathological features were more severe in the pyloric antrum than in the body, and the change in severity corresponded well with the disapperance of G cells at the body-antrum border. The transitional body-antrum zone was histopathologically similar to the remaining antrum. A marked individual heterogeneity of the histopathological alterations was observed. An increasing grade of atrophy was associated with increased severity of inflammation, and the presence of intestinal metaplasia was especially associated with atrophy. No significant correlation was found between the antral G-cell number and the grade of antral inflammatory cell infiltration, whereas there was a reduction in cell number with increasing grade of atrophy in all patient categories. The parietal-cell density in the body mucosa was decreased with increasing grade of inflammation as well as with increasing grade of atrophy. The presence of patchy intestinal metaplasia resulted in a complete absence of G cells and of parietal cells from the corresponding part of the mucosa in the antrum and body respectively.

Topics: Adult; Aged; Atrophy; Cell Count; Duodenal Ulcer; Female; Fluorescent Antibody Technique; Gastrectomy; Gastrins; Gastritis; Humans; Intestinal Mucosa; Intestines; Male; Metaplasia; Middle Aged; Pyloric Antrum; Pylorus; Staining and Labeling; Stomach Ulcer; Uremia

Stimulation of the beta-adrenergic terminations was employed to determine whether calcitonin-secreting thyroid C cells are derived from the neural crest. Calcitonin secretion was increased, whereas parathormone, insulin and gastrin values were not significantly changed. In addition, administration of a beta-blocking drug before ethanol led to a marked fall in calcitonin with respect to the baseline. Once again, other hormone levels were not affected.

Topics: Calcitonin; Gastrins; Humans; Parathyroid Hormone; Propranolol; Receptors, Adrenergic; Receptors, Adrenergic, beta; Renal Dialysis; Uremia

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 mucosal distribution of G cells was quantitatively mapped in resected stomachs from 42 patients (12 with gastric ulcer, 11 with duodenal ulcer, 14 with duodenal ulcer and uremia, and 5 with gastric cancer). Along the histological border of the proximal part of the pyloric antrum there was in all patient categories a transitional zone of varying extent, with a low G-cell density before the cells disappeared in the body of the stomach. The proximal end of the duodenum contained considerably fewer G cells than in the antrum, and the number was virtually equal in all groups. Within the antrum there was in the material as a whole a gradual increase in G-cell density from the proximal to the distal part, but this difference was not apparent for the gastric ulcer patients. When corresponding antral segments were compared between the various patient groups, the G-cell density was found to be significantly decreased in the distal antrum of the gastric ulcer patients. In all patient categories, except the duodenal ulcer group with uremia, the circumferential distribution of G cells showed reduced density along the curvatura minor. For the material as a whole there were great individual variations in the overall antral G-cell density, in the antral area corresponding to the distribution of G cells and in the total G-cell mass; these three variables were not significantly related to diagnosis, age or sex.

Topics: Adult; Aged; Cell Count; Duodenal Ulcer; Female; Fluorescent Antibody Technique; Gastrectomy; Gastric Mucosa; Gastrins; Humans; Male; Middle Aged; Pyloric Antrum; Stomach Neoplasms; Stomach Ulcer; Uremia

Topics: Adult; Aged; Blood Pressure; Female; Gastric Juice; Gastric Mucosa; Gastrins; Humans; Kidney Failure, Chronic; Lithium; Male; Middle Aged; Pepsin A; Peptic Ulcer; Permeability; Polyethylene Glycols; Renal Dialysis; Uremia

The concentrations of testosterone, cortisone, gastrin, insulin, gastric inhibitory polypeptide (GIP), somatomedin B, parathyroid hormone (PTH), human growth hormone (HGH) and thyroid stimulating hormone (TSH) have been determined in the plasma and the ultrafiltrate of five uremic patients undergoing intermittent hemofiltration treatment. There was a considerable loss of gastrin, insulin, GIP, somatomedin B and PTH by hemofiltration treatment. The plasma concentrations, however, did not decrease except for immunoreactive-PTH (IR-PTH) which returned from elevated to normal levels. Cortisone, HGH and TSH concentrations in the ultrafiltrate were below the measureable range. A significant elimination of 11-hydroxylated androstans by hemofiltration may have a positive effect on the disturbed steroid metabolism. Results indicate that hemofiltration does not cause a hormone deficiency syndrome. On the contrary, the loss of degradation products of hormones with disturbing biological activity may be a favorable effect of the hemofiltration treatment.

Topics: Cortisone; Extracorporeal Circulation; Gastric Inhibitory Polypeptide; Gastrins; Growth Hormone; Hormones; Humans; Insulin; Male; Parathyroid Hormone; Somatomedins; Testosterone; Thyrotropin; Uremia

Many alterations in metabolic and endocrine function occur in end-stage renal disease. Glucose intolerance is almost always present with uremia; it improves shortly after institution of regular hemodialysis. Hyperlipidemia (type IV) is prevalent, and atherosclerotic cardiovascular disease causes death in about 50% of patients receiving long-term hemodialysis. Although plasma levels of growth hormone usually are elevated, children with chronic renal failure show growth retardation. The occurrence of thyroid disorders is difficult to determine, since many clinical features of uremia are similar to those of hyperthyroidism and hypothyroidism. The incidence of duodenal ulcer is high, possibly due to high gastrin levels. Sex hormone disturbances are common. Anemia is a constant feature of chronic renal failure; patients usually tolerate it well.

Topics: Anemia; Blood Glucose; Gastrins; Gonadal Steroid Hormones; Growth Hormone; Humans; Hyperlipidemias; Insulin; Kidney Failure, Chronic; Renal Dialysis; Thyroid Diseases; Triglycerides; Uremia

The fasting serum concentration and the first-hour serum gastric response to a protein-rich meal were related to the antral G-cell population in 14 patients with peptic ulcer. They were divided into a uremic (n=5) and non-uremic group (n=9). Fasting serum gastrin correlated significantly with the total antral G-cell mass only in the non-uremic patients who showed a relatively narrow transitional body-antrum zone. Conversely, the integrated serum gastric response was inversely related to the size of this zone in both groups of patients. A presumptive endocrine G-cell mass was estimated by subtracting the G cells in the transitional zone from the total antral G-cell population. Total gastrin output correlated positively with this estimated mass in the non-uremic group and in the material as a whole. Also, the integrated gastrin response was positively correlated with the presumptive endocrine G-cell mass in the whole material. It was concluded that G cells in the transitional body-antrum zone, where also parietal cells are present, do not release gastrin into the circulation during meal stimulation like G cells in the remaining part of the pyloric antrum. On the basis of these results and our previous morphological observations (19), we propose that the G cells in the transitional zone are involved in a paracrine interrelationship with the surrounding parietal cells rather than contributing to the circulating pool of gastrin.

Topics: Adult; Aged; Cell Count; Duodenal Ulcer; Fasting; Female; Food; Gastric Juice; Gastrins; Humans; Male; Middle Aged; Pyloric Antrum; Stomach Ulcer; Uremia

Fortyseven uremic patients on RDT underwent a gastric secretion study and a contemporary evaluation of serum levels of Calcium (Ca), Phosphate (iP), Magnesium (Mg), Alkaline Phosphatase (AP), immunoreactive gastrin (Gas), parathyroid hormone (PTH), calcitonin (CT). Secretory test (pentagastrin 6 microgram/kg) was performed in the morning, after 12 hours of fasting, in the interdialytic interval. Female patients, male patients on RDT from less 1 year and hyposecretor patients were excluded from the study. On the basis of these criteria 25 normal or hypersecretor males between 20 and 55 years old were selected. A significant positive correlation was found between PTH and CT, while a negative significant correlation was found between CT and BAO and CT and PAO. Similarly, a significant negative correlation was found between PTH and BAO and PTH and PAO. Multiple regression study showed that the negative influence of CT on BAO and PAO is more relevant than the positive influence of PTH. These data suggest that PTH and CT are involved in gastric acid secretion in uremia. Since the inhibitory effect of CT is prevailing on the stimulating effect of PTH, patients with higher levels of PTH and CT have a lower gastric acid secretion. CT might therefore be considered as a protective factor against hypersecretion in uremia.

Topics: Adult; Alkaline Phosphatase; Antigens; Calcitonin; Calcium; Gastric Juice; Gastrins; Humans; Hyperparathyroidism, Secondary; Magnesium; Male; Middle Aged; Parathyroid Hormone; Pentagastrin; Phosphates; Renal Dialysis; Uremia

The distribution of parietal cells in the body mucosa, and of G cells in the antral mucosa, was quantitatively mapped in resected stomachs from 42 patients (12 with gastric ulcer, 11 with duodenal ucler, 14 with duodenal ulcer and uremia, and 5 with gastric cancer) who preoperatively had had their gastric acid secretion measured. In the material as a whole there was a significant positive correlation between the parietal-cell density and maximal acid output (MAO), and a significant negative correlation between the parietal-cell density and patient age. A significant positive correlation was found between the antral G-cell mass and basal acid output (BAO). When the individual patient categories were analyzed, the correlation between parietal-cell density and MAO were significant in the group with duodenal ulcer and uremia, and in the group with gastric cancer. Correlation between parietal-cell density and age was found only in the group with duodenal ulcer and uremia. There was no correlation between the parietal-cell density and various parameters of the antral G-cell population in the material as a whole or in any of the individual groups.

Topics: Adult; Aged; Cell Count; Duodenal Ulcer; Female; Gastric Juice; Gastrins; Humans; Male; Middle Aged; Peptic Ulcer; Stomach; Stomach Neoplasms; Stomach Ulcer; Uremia

Topics: Cortisone; Gastric Inhibitory Polypeptide; Gastrins; Growth Hormone; Hormones; Humans; Insulin; Male; Renal Dialysis; Somatomedins; Testosterone; Thyrotropin; Ultrafiltration; Uremia

The concentrations of testosterone, cortisone, gastrin, GIP, somatomedin B, insulin, HGH, and TSH have been determined in the plasma and the ultrafiltrate of five uremic patients undergoing intermittent hemofiltration treatment. There was a considerable loss of gastrin, GIP, somatomedin B, and insulin by hemofiltration treatment; the plasma concentrations, however, did not decrease. Cortisone, HGH, and TSH were not detectable in the ultrafiltrate. Our results therefore indicate that hemofiltration does not cause a hormone deficiency syndrome. On the contrary, the loss of degradation products of hormones with disturbing biological activity may be a favourable effect of the hemofiltration treatment.

Topics: Cortisone; Gastric Inhibitory Polypeptide; Gastrins; Growth Hormone; Hormones; Humans; Insulin; Renal Dialysis; Somatomedins; Testosterone; Thyrotropin; Ultrafiltration; Uremia

Topics: Adult; Aged; Female; Gastrins; Humans; Male; Middle Aged; Uremia

Twenty-one chronic hemodialysis patients were investigated. While only two had radiologic evidence of peptic ulceration, three had markedly elevated basal acid outputs, thirteen had significantly elevated maximal acid outputs and seven had fasting duodenogastric reflux. Elevated fasting serum gastrin levels and prolonged gastrin circulation following stimulated endogenous release were also demonstrated. The abnormalities in gastric function may be explained by fasting and stimulated hypergastrinemia.

Topics: Adult; Female; Gastric Juice; Gastrins; Gastrointestinal Hemorrhage; Humans; Hypercalcemia; Kidney Transplantation; Male; Middle Aged; Peptic Ulcer; Renal Dialysis; Uremia

In 37 patients with hypertension and/or renal disease, blood from a peripheral and a renal vein was drawn during renal vein catheterization. The serum gastrin concentrations were determined and found by paired comparison to be statistically significantly (p less than 0.05) higher in the peripheral than in the renal vein. A test meal was given to 9 male controls and 7 male azotemic patients, and the serum gastrin concentration response determined. The mean fasting serum gastrin values were 173 +/- 22 pg/ml in the group of patients versus 42 +/- 5.5 pg/ml in the controls. The serum gastrin response was significantly higher and of longer duration in the azotemic patients than in the controls. The pentagastrin-stimulated gastric acid secretion was, however, equal in the two groups.

Topics: Digestion; Eating; Fasting; Food; Gastric Juice; Gastrins; Humans; Hypertension; Male; Pentagastrin; Secretory Rate; Stimulation, Chemical; Uremia

Topics: Anemia, Pernicious; Duodenal Ulcer; Gastrectomy; Gastrins; Humans; Uremia; Zollinger-Ellison Syndrome

Topics: Adult; Duodenal Ulcer; Female; Gastric Juice; Gastrins; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Radioimmunoassay; Renal Dialysis; Secretory Rate; Stomach; Uremia

Topics: Calcium; Creatinine; Fasting; Food; Gastrins; Humans; Renal Dialysis; Stomach; Time Factors; Uremia

Topics: Acute Kidney Injury; Animals; Blood Urea Nitrogen; Gastrins; Humans; Iodine Radioisotopes; Kidney; Ligation; Male; Nephrectomy; Nitrogen; Radioimmunoassay; Rats; Uremia; Ureter

Topics: Adrenal Cortex Hormones; Gastrins; Humans; Hydrogen-Ion Concentration; Immunosuppression Therapy; Kidney Failure, Chronic; Kidney Transplantation; Peptic Ulcer; Postoperative Complications; Transplantation, Homologous; Uremia