Biochemical study on gastrin, secretin and somatostatin homeostasis in end stage renal failure

Chronic renal failure is a complex disease that is associated with enormous biochemical alterations which induce marked multiorgan dysfunctions. Gastrointestinal disorders are diagnosed occasionally while renal failure is not yet recognized. The specific mechanisms underlying these complaints are not yet completely known. Aim: The present study aimed to assess the circulating state of three major biologically active gut hormones i.e. gastrin, secretin and somatostalin. Their responses to standard test meal and to hemodialysis were also determined The present study was conducted on 20 patients with CRFdue to variable kidney diseases. Of them 10 patients receiving conservative treatment only [Conservative group] and the remaining 10 patients undergoing maintenance hemo-dialysis [hemodialysis group] beside the conservative therapy. Also 12 healthy volunteers were similarly investigated. Plasma total gastrin, secretin and somatostatin [S.S] concentrations beside the routine investigations were determined. In conservative uremic group, fasting and one hour postprandial plasma total gastrin, secretin and somatostatin levels were significantly higher than their corresponding normal control levels: Moreover, test meal induced significant increase in these hormones in both CRF and control groups in comparison to their fasting levels. In hemodialysis uremic patients, plasma total gastrin, secretin and somatostatin concentrations before dialysis were significantly higher than their corresponding levels in the normal control and in conservative uremic groups. Hemodialysis caused significant reduction of the circulating gastrin, secretin and somatostatin concentrations when compared with their plasma concentrations before dialysis. However, in hemodialyzed uremics, unlike plasma gastrin and secretin concentrations, plasma SS concentration before dialysis was not significantly different from the fasting level in CRF patients on conservative therapy. Hypersecretinemia and hypersomatostatinemia were concomitant finding with hypergastrinemia in CRF. Disproprotionate synthesis and release of gastrin, secretin and somatostatin can be explained by impairment of the feedback loops and cross regulations in between these hormones. However, being excreted mainly by kidney, impaired excretion of these hormones is also a possible cause of their high circulating concentrations.