Abstract
In order to evaluate gastric motility in patients undergoing hemodialysis (HD), we measured gastric emptying (GE) in 25 HD patients (8 diabetics, 17 non-diabetics) by the radioisotope method. Autonomic nerve function and gut hormone levels were also examined.
99mTc-labeled solid and liquid meals were used for the estimation of GE. Percentage of gastric retention (GR) of RI at 60 min after ingestion of a solid meal, and the half time (T1/2) of a labeled liquid meal were used as indicators marker of GE. GE was also measured in 6 normal controls. Autonomic nerve function was evaluated by the RR interval on an electrocardiogram (CVR-R), and gut hormone, gastrin and motilin levels were measured before starting hemodialysis.
A significant positive relationship was observed between the value of GR of a solid meal and the T1/2 of a liquid meal. The values of GR of a solid meal in HD diabetics (72.0±11.3%) were significantly higher than those in HD non-diabetics (59.2±14.3%) and controls (50.1±9.9%). The mean values of T1/2 of a liquid meal were 103.1 min in HD non-diabetics, and 162.3 min in HD diabetics, which were significantly higher than the values in controls (mean 49.5 min). There was no significant relationship between GE and gut hormone level in either group. Although there was no relationship between GE and CVR-R in HD non-diabetics, autonomic nerve dysfunction as evaluated by CVR-R was observed in all HD diabetics.
It is suggested that in HD diabetics autonomic nerve dysfunction might result in disturbed GE of both solid and liquid meals. In HD non-diabetics, the pathogenesis of disturbed GE should be further investigated.
