Small intestinal function and structure in patients with chronic renal failure.
We studied 24 patients with end-stage chronic renal failure not treated with hemodialysis (CRF1) and 16 patients on regular hemodialysis (CRF2), to investigate the digestive, absorptive and morphological aspects of the small intestinal mucosa. Serum d-xylose test and biochemical parameters of absorption (serum calcium and proteins) were determined. Jejunal mucosal biopsies were obtained and tissue homogenates assayed for disaccharidases (sucrase, maltase and lactase) and dipeptidases (glycyl-glycinase, leucyl-glycinase and leucyl-aminopeptidase). Histological changes were classified according to the severity of abnormality and compared with biopsies obtained from control subjects. Serum d-xylose test, calcium and proteins were normal in patients with CRF. Maltase specific activity was higher in CRF1 than in controls (p less than 0.05). Lactase and leucyl-aminopeptidase showed a tendency to decrease in CRF, but this difference did not reach statistical significance. Sucrase, glycyl-glycinase and leucyl-glycinase specific activity in CRF was similar to the control group. Histological changes of the small intestinal mucosa of mild to moderate degree were noted in 68% of patients with CRF vs 36% in control subjects (p less than 0.01). No significant difference was noted in the incidence of absorptive, enzymatic (with the exception of maltase) and histological changes between the two groups of patients with CRF. These changes are not influenced by hemodialysis, a long-term treatment averaging 6 months, they appear to represent primary manifestations of CRF and may be related to the nutritional status of patients with CRF.
Arvanitakis
C
C
First Department of Medicine, University of Thessaloniki, AHEPA General Hospital, Greece.
Nakos
V
V
Kalekou-Greka
H
H
Tourkantonis
A
A
D000328:Adult; D000368:Aged; D001706:Biopsy; D004150:Dipeptidases / Q000032:analysis; D004186:Disaccharidases / Q000032:analysis; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000201:enzymology / Q000473:pathology*; D007583:Jejunum / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D004186:Disaccharidases; D004150:Dipeptidases