Influence of dialysate on gastric emptying time in peritoneal dialysis patients.
OBJECTIVE
Peritoneal dialysis (PD) patients frequently suffer from dyspeptic complaints such as nausea, vomiting, abdominal distension, early satiety, and anorexia. Gastroparesis might be, at least partially, a source of dyspeptic complaints in PD patients. The aim of the present study was to determine the influence of the presence and composition of dialysate on gastric emptying in PD patients.


METHODS
Prospective study.


METHODS
Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.


METHODS
Sixty-one PD patients using different dialysate solutions, and 27 healthy volunteers.


METHODS
Gastric emptying of solids was assessed by the 13C-octanoic acid breath test.


RESULTS
Gastric emptying was impaired in PD patients, regardless of the composition of dialysate and even if tested with an empty peritoneal cavity. Gastric emptying was significantly slower when glucose-containing dialysate was compared to an empty peritoneal cavity, or when glucose-containing dialysate was compared to icodextrin dialysate. No difference in gastric emptying could be demonstrated between glucose-containing dialysate and dialysate containing a mixture of glycerol and amino acids as osmotic agent.


CONCLUSIONS
These findings suggest that the delay in gastric emptying demonstrated in the presence of peritoneal dialysate is not the consequence of a mere volume or pressure effect, but of the absorption of substrate substances with caloric and/or metabolic activity, such as glucose or glycerol and amino acids.
Van
VlemBrunoA
V
Department of Internal Medicine, Ghent University Hospital, Belgium. bruno.vanvlem@rug.ac.be
Schoonjans
Renaat S
RS
Struijk
Dirk G
DG
Verbanck
Johan J
JJ
Vanholder
Raymond C
RC
Van
BiesenWimV
B
Lefebvre
Romain A
RA
De
VosMartineP
V
Lameire
Norbert H
NH
D000328:Adult; D015992:Body Mass Index; D001944:Breath Tests; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D015314:Dialysis Solutions / Q000009:adverse effects* / Q000737:chemistry; D005746:Gastric Emptying / Q000187:drug effects*; D018589:Gastroparesis / Q000209:etiology* / Q000503:physiopathology; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011446:Prospective Studies
D015314:Dialysis Solutions; D005947:Glucose