Korean Journal of Nephrology 1992;11(1):49-55.

상부 위장관 증상이 있는 만성 신부전 환자에 있어 위 내용물 배출 시간측정 및 Cisapride 효과 평가

이오영 , 이규택 , 양석철 , 이종철 , 박찬현 , 강종명 , 박한철 , 조석신

Abstract

The patient with delayed gastric emptying time have dysfunctional upper gastrointestinal symptoms such as nausea, vomiting, postprandial bloating and anorexia. Many of the patients with chronic renal failure have dysfunctional upper gastrointestinal symptoms. We performed gastric emptying time using gamma camera in the patients with chronic renal failure to know the cause of dysfunctional upper gastrointestinal symptom in these patients. Mixed meal with 99 m Tc Tin-colloid labelled chicken liver were used as a solid marker by in vivo techinque. And chronic renal failure patients with delayed gastric emptying time were given Cisapride 5 mg t.I.d. for three weeks. The result as followings; 1) We studied gastric emptying time of solid food in 22 patients. All patients had chronic renal failure and were maintained on a regular schedule of hemodiaysis. The symptomatic group consisted of ten patients with dysfunctional upper gastrointestinal symptoms such as nausea, vomiting, postprandial bloating, epigastric dis- comfort and anorexia.(Four men and six women; mean age, 51.9 years) The asymptomatic group consisted of twelve patients (seven men and five women; mean age, 43.1 years). The nonnal control group were twenty in number (sixteen men and four women; mean age, 29.2 years). Both groups were compared with a group of normal subjects. 2) The gastric emptying time (T) of the chronic renal failure patients without dysfunctional upper gas- trointestinal symptoms was not statistically different from that of normal contorl group but the gastric empt- ing time (T 1/2) of the chronic renal failure patients with dysfunctional upper gastrointestinal symptoms was delayed significantly compared to that of normal con- trol group (150.5±25.5 VS 84.9±16.4 mins)(p<0.05) and also, to that of the chronic renal failure patients without dysfunctional upper gastrointestinal symptoms (150.5± 25.5 vs 89.9±15.2 min)(p<0.05). 3) Follow up gastric emptying time (T,) of all chronic renal failure patients'with dysfunctional upper gastrointestinal symptoms after Cisapride treatment was improved significantly than initial gastric empting time (T,) (99.1±6.6 VS 150.5±25.5 mins) (p<0.05). And also, Cisapride significantly promote dysfuntional gastrointestinal symptoms such as nausea, vomiting, postprandial, fullness bloating and anorexia (0.9±0.7 VS 4.9±1.6 symptoms scores)(p<0.05). 4) Mild abdominal pain was experienced only in one patient with Cisapride, but, this was not severe enough to require discontinuing the study. 5) Follow up CBC, GOT, GPT and electrolyte of patients with Cisapride treatment were not significatly different form initial data. These results suggest that gastric empting time is delayed in the chronic renal failure patients with dysfun- ctional upper gastrointestinal symptoms. And this delayed gastric empting time may cause the dysfun- ctional upper gastrointestinal symptoms. This was supported by the fact that gastric empting time and upper gastrointestinal symptom were improved with Cisapride.