Impaired fecal elastase excretion in uremic pancreopathy

To evaluate pancreatic exocrine function in uremia, 25 patients undergoing regular hemodialysis without clinical evidence of pancreatic disease and 25 healthy control subjects were studied by fecal clastase 1 and chymotrypsin . Abdominal ultrasonography and measurement of serum lipase, calcium, phosp hate, and pararhormone were also carried out. Fecal elastase was significan tly lower (P < 0.001) in patients than in controls. Abnormally low values w ere found in 12/25 patients of whom six had values <100 mug/g. Fecal chymot rypsin was significantly lower (P < 0.05) in patients than in controls, wit h lower than normal values found in 10/25 patients. Fecal elastase was not related to the serum calcium, phosphate, or parathormone levels or to the p eriod of dialysis. In patients serum lipase was normal or slightly elevated (<300 units/liter), and there was no evidence of pancreatic disease at ult rasound examination. The results lend further support to the existence of p ancreatic function impairment in a significant number of patients with rena l failure despite the absence of clinical and morphological evidence of pan creatic disease.