Plasma Gastrin Levels and Gastric Acid Secretion in Chronic Renal Failure

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Plasma gastrin levels and gastric acid secretion were examined in 17 patients with chronic renal failure on maintenance hemodialysis and 22 normal subjects. Plasma gastrin levels were measured using radioimmunoassay. Gastric analysis was performed by intramuscular injection of tetragastrin (4 μg per kg). Gastroduodenal endoscopy was performed in all patients. Fasting plasma gastrin levels were 421.1±320.8pg/ml (mean±S. D.), while those of normal subjects were 54.7±51.5pg/ml. Basal acid output was less than 1.0mEq/h in 77% of the patients, and one hour acid output was less than 10.0mEq in 71%. No increase in grastric acid secretion was observed both in basal condition and following tetragastrin stimulation in spite of the presence of hypergastrinemia. None of the patients had peptic ulcer endoscopically, except that one patient had a few erosions on the antral mucosa. Our observations were inconsistent with the former reports from European countries that increased gastric acid secretion and peptic ulcer were more frequently observed in patients with chronic renal failure. These data may suggest that atrophic gastritis preceded the occurrence of renal failure in these patients, or that other factors inhibited the gastric secretion.
東海大学の論文