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Abstract
Background. Patients with chronic kidney failure have an increased incidence of gastrointestinal
complications, particularly bleeding from the stomach. Diminished mucosal blood flow
is thought to be an important etiologic factor for such bleeding.
Methods. Eleven patients with kidney failure on maintenance dialysis underwent placement of
a gastric tonometer for the determination of gastric intramucosal pH (pHi) before and during dialysis. The arterial pH (pHa), calculated pHi, and pHa — pHi differences were compared with the results in a control group of seven normal volunteers.
Results. The patients with chronic kidney failure had a mean (+-SD) pHa (7.36 ± 0.04) similar to that found in seven control subjects (7.37 ± 0.04). However,
the gastric mucosal pH in the patients on dialysis (7.20 ± 0.17) was lower than in
the seven control subjects (7.38 ± 0.06) (p < 0.01). A gastric mucosal pH thought
to be predictive of either bleeding from stress ulceration (pHi < 7.32) or mucosal ischemia (pHi — pHa difference > 0.13) was found in nine (82%) of the patients with kidney failure and
in only one (14%) of the control subjects (p < 0.001).
Conclusions. This new preliminary finding suggests that the high incidence of gastric bleeding
in chronic kidney failure may be related to mucosal ischemia.
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Article info
Publication history
Accepted:
January 24,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.
