IMPAIRED GASTRIC MYOELECTRICAL ACTIVITY IN PATIENTS WITH CHRONIC-RENAL-FAILURE

Dysmotility and delayed emptying of the stomach have been reported in patients with chronic renal failure (CRF). The aim of this study was t o investigate whether gastric myoelectrical activity was impaired in p atients with CRF using electrogastrography. The electrogastrogram (EGG ) was recorded in 24 symptomatic patients with CRF (15 with diabetes) and 12 normal subjects. Two 30-min EGG recordings before and after a t est meal were analyzed using spectral analysis methods. It was found t hat patients with CRF showed a significantly lower percentage of norma l 2-4 cpm slow waves in both fasting and fed states in comparison with healthy controls (in fasting state: 88.9 +/- 2.5% vs 67.4 +/- 6.6%/63 .2 +/- 7.0%, P < 0.01; in fed state: 89.6 +/- 1.8% vs 64.6 +/- 6.2%/62 .0 +/- 8.3%, P < 0.01; controls ys diabetic patients/nondiabetic patie nts). Both patient groups showed a significantly higher prevalence of the abnormal EGG, which was defined as the percentage of 2-4 cpm slow waves lower than 70% (fasting state: 8% vs 60%/56%, P < 0.01/0.05; fed state: 0% vs 53%/56%, P < 0.005/0.002; controls vs diabetic patients/ nondiabetic patients). No significant difference was observed in the r egularity of the gastric slow waves between the two patient groups. Th e healthy controls showed a significant increase in the dominant power and frequency of the EGG after the test meal. However, this increase was absent in the two patient groups. It was concluded that patients w ith chronic renal failure have abnormal gastric myoelectrical activity , including impaired regularity of the gastric slow wave and a failed increase in the power of the EGG at 3 cpm. Electrogastrography is an a ttractive noninvasive method for the study of gastric motility in pati ents with severe chronic renal failure.