Department of Nephrology, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
Department of Anaesthesiology, University of Hong Kong Shenzhen Hospital, Shenzhen, China.
Ren Fail. 2022 Dec;44(1):329-335. doi: 10.1080/0886022X.2022.2030754.
This study aimed to assess the gastric emptying capacity in nondiabetic patients with end-stage kidney disease (ESKD) by ultrasound.
Consecutive hemodialysis patients with ESKD ( = 37) and healthy controls ( = 37) were enrolled. All ESKD patients underwent ultrasound examinations on the day of hemodialysis (dialysis day) and the day after hemodialysis (nondialysis day). Standard ultrasound examinations were performed after overnight fasting, immediately after a light meal, and at 6 h after a meal. The antral cross-sectional area and gastric emptying according to the Perlas grading system were evaluated.
Compared with the controls, patients with ESKD, on both dialysis and non-dialysis days, had significantly larger antral areas when examined in the supine position ( = 0.002 and = 0.003, respectively), but not in the right lateral decubitus position ( = 0.452 and = 0.512, respectively). In the supine position, the antral area of ESKD patients before dialysis (8 a.m. on the dialysis day) was larger than that at the same time on the nondialysis day ( = 0.028). The controls had a Perlas grade of either 0 or 1 at 6 h after a meal, whereas five patients (13.5%) and 11 patients (29.7%) in the ESKD group had Perlas grade 2 on the dialysis and non-dialysis days, respectively. Among patients with or without delayed gastric emptying, no differences were detected in the dialysis duration or levels of biochemical markers, except blood urea nitrogen ( = 0.038) and serum creatinine ( = 0.003).
Nondiabetic patients with ESKD had significantly delayed gastric emptying. Hemodialysis might improve gastric emptying and reduce gastric emptying delay.
本研究旨在通过超声评估非糖尿病终末期肾病（ESKD）患者的胃排空能力。
连续纳入接受血液透析的 ESKD 患者（ = 37）和健康对照者（ = 37）。所有 ESKD 患者在血液透析日（透析日）和血液透析后第 1 天（非透析日）进行超声检查。所有患者均在隔夜禁食后、进餐后即刻和餐后 6 小时进行标准超声检查。根据 Perlas 分级系统评估胃窦横截面积和胃排空情况。
与对照组相比，透析日和非透析日仰卧位时 ESKD 患者的胃窦面积均显著增大（ = 0.002 和 = 0.003），但右侧卧位时无显著差异（ = 0.452 和 = 0.512）。在仰卧位，透析日 8 点（透析前）ESKD 患者的胃窦面积大于同日非透析日（ = 0.028）。对照组餐后 6 小时的 Perlas 分级均为 0 或 1 级，而 ESKD 组分别有 5 例（13.5%）和 11 例（29.7%）在透析日和非透析日时达到 2 级。在胃排空延迟患者和非延迟患者中，除了血尿素氮（ = 0.038）和血清肌酐（ = 0.003）外，透析时间或生化标志物水平均无差异。
非糖尿病 ESKD 患者的胃排空明显延迟。血液透析可能改善胃排空，减少胃排空延迟。
