Assessment of esophageal motility disorders in chronic renal failure

ABSTRACT

In patients with chronic renal failure [CRF] anorexia, nausea, and vomiting are common yet poorly understood symptoms. The study aimed to examine motor function disturbances of the esophagus as well as modulating hormonal factors and its effect on nutritional status in patients with [CRF] .We studied 50 patients stratified into 3 groups G1 25 patients with [CRF], on hemodialysis, G2 25 patients with [CRF], on conservative treatment and G3 ten subjects with abnormal upper GI. Manifestations, but with normal renal functions. S. gastrin and S. albumin were examined in all groups and esophageal manometric assay was done for all. At presentation G1 showed the presence of elevated lower esophageal sphincter pressure and incomplete lower sphincter relaxation with elevated residual pressure on relaxation associated with low percentage of relaxation on wet swallows. In addition to a high amplitude and prolonged duration of esophageal contractions as compared to G3, this was associated with hypergastrinemia and low S. albumin. Moreover G2 showed the same results as for G1, plus a high percentage of uncoordinated contractions as compared to G3, but it lacks high amplitude and prolonged duration of esophageal contractions . We conclude that esophageal motility abnormalities and elevated serum gastrin may be a consequence of [CRF], in addition, elevated serum gastrin may play an important role in initiating these abnormalities and that esophageal manometry should thus be considered for patients with CRF presenting with gastrointestinal upsets