Exocrine pancreatic function in patients with end-stage renal disease
Autor: | Patrick Maisonneuve, J Griesche-Philippi, Paul Georg Lankisch, J. Otto, H Schwörer |
---|---|
Rok vydání: | 2010 |
Předmět: |
Diarrhea
Male medicine.medical_specialty medicine.medical_treatment Nutritional Status Severity of Illness Index Gastroenterology Peritoneal dialysis End stage renal disease Feces Renal Dialysis Germany Internal medicine medicine Humans Exocrine pancreatic insufficiency Aged Pancreatic Elastase business.industry Malnutrition digestive oral and skin physiology General Medicine Middle Aged medicine.disease Lipids Pancreas Exocrine Steatorrhea Cross-Sectional Studies Treatment Outcome medicine.anatomical_structure Nephrology Kidney Failure Chronic Acute pancreatitis Pancreatitis Exocrine Pancreatic Insufficiency Female Hemodialysis medicine.symptom business Pancreas |
Zdroj: | Scopus-Elsevier Europe PubMed Central |
ISSN: | 0301-0430 |
Popis: | AIM malnutrition is a common problem in patients with end-stage renal disease (ESRD). Several studies showed 30 years ago that more than half of patients with ESRD suffered from exocrine pancreatic insufficiency. However, the studies never investigated whether the functional impairments led to morphological changes of the pancreas or to steatorrhea and thus indicating the need for lifelong pancreatic enzyme substitution. Our goal was therefore not only to establish the frequency but also the severity of exocrine pancreatic insufficiency in hemodialysis patients. METHODS the study included 50 hemodialysis patients with no history of acute or chronic pancreatitis or upper abdominal symptoms of uncertain origin. All patients with hyperthyroidism, status post-gastrectomy or (partial) small bowel resection, or chronic inflammatory bowel disease were excluded. In all 50 patients, fecal elastase-1 was determined using two different methods (Bioserv Diagnostics and ScheBo Biotech) and fecal fat content and fecal weight were measured. RESULTS mild to moderate exocrine pancreatic insufficiency (elastase-1 100 - 200 microg/g stool) was found in 10% of patients. It was not correlated with age, sex, and underlying renal disease, duration of hemodialysis, or diarrhea and steatorrhea. In no patient was the enzyme content < 100 microg/g stool, i.e., it never sank to a level at which pancreatic enzyme substitution would have been recommended. Nine patients (18%) had mild diarrhea (200 - 300 g stool/ day), and 10 (20%) had mild steatorrhea (7 - 15 g fat/day in the stool). Five patients had both diarrhea and steatorrhea. CONCLUSIONS mild to moderate but not severe exocrine pancreatic insufficiency is not infrequent in patients on hemodialysis but unlikely to be responsible for malnutrition in ESRD. Non-pancreas-related steatorrhea is also not uncommon. This finding requires further analysis because steatorrhea might influence nutrition, thus potentially opening the way to new therapeutic approaches. |
Databáze: | OpenAIRE |
Externí odkaz: |