Sirinek K R, O'Dorisio T M, Gaskill H V, Levine B A
Am J Surg. 1984 Dec;148(6):732-5. doi: 10.1016/0002-9610(84)90426-4.
Fifteen patients with chronic renal failure (serum creatinine level greater than 5 mg/dl) of long duration (more than 2 years) requiring hemodialysis were studied. Blood samples before and after 4 hours of hemodialysis were assayed for creatinine, blood urea nitrogen, potassium, calcium, glucose, insulin, gastrin, gastric inhibitory polypeptide, vasoactive intestinal polypeptide, pancreatic polypeptide, somatostatin, motilin, and neurotensin levels. Before dialysis, serum gastrin was minimally increased whereas gastric inhibitory polypeptide and pancreatic polypeptide were grossly increased compared with normal fasting values. Hemodialysis produced no changes in serum gastric inhibitory polypeptide, vasoactive intestinal polypeptide, pancreatic polypeptide, somatostatin, motilin, and neurotensin. Slight increases in serum insulin and gastrin levels may have occurred secondary to a dialysis-induced increase in the serum calcium level. The kidneys appear to be a major site of inactivation of insulin, gastrin, gastric inhibitory polypeptide, and pancreatic polypeptide. The gastrin level, although elevated in renal failure patients, may be suppressed by very high circulating levels of gastric inhibitory polypeptide.
对15例慢性肾衰竭（血清肌酐水平大于5mg/dl）且病程较长（超过2年）需要进行血液透析的患者进行了研究。在血液透析4小时前后采集血样，检测肌酐、血尿素氮、钾、钙、葡萄糖、胰岛素、胃泌素、胃抑制性多肽、血管活性肠肽、胰多肽、生长抑素、胃动素和神经降压素水平。透析前，血清胃泌素仅有轻微升高，而与正常空腹值相比，胃抑制性多肽和胰多肽显著升高。血液透析对血清胃抑制性多肽、血管活性肠肽、胰多肽、生长抑素、胃动素和神经降压素无影响。血清胰岛素和胃泌素水平略有升高可能继发于透析诱导的血清钙水平升高。肾脏似乎是胰岛素、胃泌素、胃抑制性多肽和胰多肽失活的主要部位。肾衰竭患者的胃泌素水平虽有所升高，但可能被循环中非常高的胃抑制性多肽水平所抑制。
