Abstract
Impairment of pancreatic exocrine function in uremia has long been discussed. The present study was performed to evaluate pancreatic exocrine function in 11 uremic patients during the initial phase of hemodialysis therapy using direct tests, and the relationship between pancreatic exocrine function and metabolic acidosis was examined.
The subjects consisted of 7 men and 4 women with a mean age of 45.5 years, none of whom had a history of pancreatitis or alcohol abuse. Pancreatic exocrine function was evaluated using the secretin test, i.e., duodenal aspirate analysis of pancreatic juice after rapid intravenous injection of 100 units of secretin. The secretory parameters analyzed to assess pancreatic exocrine function were total volume (per 60min) of duodenal juice secreted (Vol), maximal bicarbonate concentration (MBC) in any fraction of duodenal juice collected, and total amylase output (AO).
The results of the secretin test, yielded a mean Vol of 4.7±1.0ml/kg (mean±SD) and mean AO of 3, 396±2, 038SU/kg, both significantly above the normal range (p<0.05), while the mean MBC was within normal limits (97±37mEq/l). In addition, a significant positive correlation was detected between Vol and blood pH (r=0.819, p<0.05), but there was no significant correlation between metabolic acidosis and MBC or AO.
Although long-term hemodialysis patients have been described as exhibiting impaired exocrine pancreatic function, our study suggests that the uremic patients display hypersecretion of Vol and AO during the initial phase of hemodialysis therapy. Therefore, changes in pancreatic exocrine function during the course of hemodialysis should be further investigated.
