Gastric emptying in diabetic and non-diabetic patients on continuous ambulatory peritoneal dialysis

Abstract

As anorexia is common in continuous ambulatory peritoneal dialysis (CAPD) particularly in diabetic patients, we conducted this study to investigate gastric motility and the effect of 2 L of intraperitoneal dialysate in diabetic (DM) and non-diabetic (NDM) CAPD patients. A standard test meal labeled with technetium-99m was given after an overnight fast to 11 DM and 10 asymptomatic NDM CAPD patients (matched for age and sex) on two occasions, each 1 week apart, with an empty (postdrainage) and 2 L dialysate- filled (pre-drainage) peritoneal cavity. Serial anterior images of the abdomen were taken in a standard manner for up to 2 h. The percentage of radioactivity retained at the end of 2 h (%2h), half emptying time (ET( 1/4 )), and emptying rate (ER) were determined. These three parameters were also obtained from six normal individuals matched for age and sex. The mean age was 53.9 for NDM and 54 for DM patients; the mean dialysis duration was 37.9 and 22.3 months, respectively. The mean age in the control group was 49.5. Comparing the DM and NDM groups individually and with the control group, there were no statistical differences in the three gastric emptying parameters, but the latter were slightly more often abnormal in DM (8) than in NDM (6) patients. There was also a significant difference in the fractional changes of all three parameters pre- and postdrainage in the DM group, but not in the NDM group. We conclude that gastric emptying is impaired in the presence of peritoneal dialysate in DM but not in NDM patients. These findings may explain the higher prevalence of anorexia among DM CAPD patients.