GASTRIC DYSRHYTHMIA IN UREMIC PATIENTS ON MAINTENANCE HEMODIALYSIS

Background: Dyspeptic symptoms are common in uremic patients receiving hemodialysis. Investigators have placed emphasis on the changes in hi stopathology and physiology of the gastrointestinal tract. But not muc h data about the gastric myoelectric activity are available. The aim o f this study was to assess gastric myoelectric activity in uremic pati ents undergoing hemodialysis. Methods: Fifty-eight subjects were enrol led. They were assigned to: group I, uremic patients undergoing hemodi alysis with dyspeptic complaints (n = 20); group II, non-uremic patien ts with matched dyspeptic complaints (n = 20); and group III, healthy volunteers without dyspeptic complaints (n = 18). Gastric myoelectric activity was measured with abdominal surface electrodes in each person . Patients in group I were measured twice, before (group Ia) and after (group Ib) hemodialysis. The data were compared between the groups. R esults: In the prehemodialysis period there was a significantly lower percentage of normal slow-wave frequency when compared with group III (fasting, 66.54% +/- 5.39% versus 84.58% +/- 3.63%; P < 0.005; fed, 72 .25% +/- 4.16% versus 89.06% +/- 2.57%; P < 0.01). In the post-hemodia lysis period the difference was even more profound (fasting, 46.52% +/ - 4.26% versus 84.58% +/- 3.63%; P < 0.001; fed, 51.49% +/- 6.89% vers us 89.06% f 2.57%; P < 0.05). Yet, when compared with group II, a sign ificant difference existed only in the post-hemodialysis period (fasti ng, 46.52% +/- 4.26% versus 67.30% +/- 3.46%; P < 0.001; fed, 51.49% /- 6.89% versus 70.41% +/- 4.39%; P < 0.01). Another finding is that h emodialysis decreased the gastric myoelectric activity after hemodialy sis (fasting, 66.54% +/- 5.39% versus 46.52% +/- 4.26%; P < 0.001; fed , 72.25% +/- 4.16% versus 51.49% +/- 6.89%; P < 0.005). Conclusions: U remic patients undergoing hemodialysis have impaired gastric myoelectr ic activity. Interestingly, hemodialysis seems to cause deterioration in gastric myoelectric activity.