Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942012000100006
Brazilian Journal of Anesthesiology
Clinical Information

Estudo do esvaziamento gástrico por cintilografia em pacientes com insuficiência renal crônica

Gastric emptying study by scintigraphy in patients with chronic renal failure

Eunice Sizue Hirata; Maria Aparecida Mesquita; Gentil Alves Filho; Edwaldo Eduardo Camargo

http://dx.doi.org/10.1590/S0034-70942012000100006 Braz J Anesthesiol, vol.62, n1, p.43-47, 2012
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Resumo

JUSTIFICATIVA E OBJETIVOS: O presente estudo teve como objetivo o esvaziamento gástrico (EG) nos pacientes com insuficiência renal crônica (IRC). MATERIAL E MÉTODO: Foram estudados 30 pacientes com IRC, 16 em tratamento clínico conservador (TCC) e 14 em hemodiálise (THD) há mais de seis meses. O grupo-controle (CTL) foi constituído por 18 voluntários assintomáticos. O método de estudo do esvaziamento gástrico (EG) foi a cintilografia. A refeição-teste padronizada foi uma omelete de três ovos de galinha preparada com enxofre coloidal marcado com 185 MBq de tecnécio-99 m. Foram estudados as curvas de retenção gástrica e, a partir delas, obtido o T½ do EG. Considerou-se normal o valor de T½ correspondente à média dos valores de T½ do grupo-controle mais duas vezes o desvio-padrão. Os testes estatísticos utilizados foram o de χ² e o de Kruskal Wallis. RESULTADOS: Não houve diferença estatisticamente significativa em relação às curvas de retenção gástrica total e ao T½ de EG, que foi semelhante nos três grupos estudados. Nove pacientes apresentaram T½ de EG elevado, acima de 125 minutos. Estes pacientes estavam igualmente distribuídos entre ambos os sexos e entre os grupos TCC e THD. CONCLUSÕES: Concluiu-se que a taxa de retenção gástrica e o T½ de EG em pacientes com IRC em TCC e THD não difere do grupo de pacientes sadios. A hemodiálise não parece diminuir o risco de retenção gástrica em pacientes com IRC

Palavras-chave

CIRURGIA, COMPLICAÇÕES, DROGAS, FARMACOLOGIA

Abstract

BACKGROUND AND OBJECTIVES: This study had the purpose of studying gastric emptying in patients with chronic renal failure. MATERIAL AND METHOD: Thirty patients with chronic renal failure were studied, 16 in conservative clinical treatment and 14 in hemodialysis for over six months. The control group (CTL) was composed of 18 asymptomatic volunteers. The method of gastric emptying study was scintigraphy. The standardized test meal was an omelet of three chicken eggs prepared with colloidal sulfur marked with 185 MBq of 99 m technetium. Gastric retention curves were studied and T½ of gastric emptying was obtained from them. A T½ value corresponding to the average of T½ values of control group plus twice standard deviation was considered nornmal. Statistical tests used were χ2 and Kruskal-Wallis. RESULTS: There was no statistically significant difference with regard to total gastric retention curves and T½ of gastric emptying, which was similar in three studied groups. Nine patients had high T½ of gastric emptying, above 125 minutes. These patients were equally distributed among both genders and conservative clinical treatment and hemodialysis groups. CONCLUSIONS: We concluded that gastric retention rate and T½ of gastric emptying in patients with chronic renal failure in conservative clinical treatment and hemodialysis does not differ from the healthy patients group. Hemodialysis does not seem to reduce the risk of gastric retention in patients with chronic renal failure

Keywords

Renal Insufficiency, Gastric Emptying, Radiopharmaceuticals, Fasting, Renal Dialysis, Perioperative Care

References

Goldstein H, Murphy D, Sokol A. Gastric acid secretion in patients undergoing chronic dialysis. Arch Intern Med. 1967;120:645-653.

Brown-Cartwright D, Smith HJ, Feldman M. Gastric emptying of an indigestible solid in patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Gastroenterology. 1988;95:49-51.

Strid H, Simrén M, Stotzer PO. Delay in gastric emptying in patients with chronic renal failure. Scand J Gastroenterol. 2004;39:516-520.

Dimitrascu DL, Barnet J, Kirschner T. Astral emptying of semisolid meal measured by real-time ultrasonography in chronic renal failure. Dig Dis Sci. 1995;40:636-644.

Ravelli AM. Gastrointestinal function in chronic renal failure. Pediatr Nephrol. 1995;9:756-762.

Dimitrascu DL, Barnet J, Kirchner T. Delayed gastric emptying in non-diabetic chronic renal failure (CRF): evidence of «uremic gastroparesis». Gastroenterology. 1993;104(4).

Margolis DM, Saylor JL, Geisse D. Upper gastrointestinal disease in chronic renal failure: a prospective evaluation. Arch Inter Med. 1978;138:1214-1217.

Kallar SK, Everett LL. Potencial risks and preventive measures for pulmonary aspiration: new concepts in preoperative measures for pulmonary aspiration: new concepts in preoperative fasting guidelines. Anesth. Analg. 1993;77:171-182.

Hadjiyannakis EJ, Evans DB, Smellie WAB. Gastrointestinal complication following renal transplantation. Lancet. 1971;2:781-785.

Vantrappen G. Methods to study gastric emptying. Dig Dis Sci. 1994;39(^sSuppl):91S-94S.

Lorena SLS, Tinois E, Hirata ES. Estudo do esvaziamento gástrico e da distribuição intragástrica de uma dieta sólida através da cintilografia: diferença entre sexos. Arq Gastroenterol. 2000;37(2):102-106.

Knight LC, Parkman HP, Brown KL. Delayed gastric emptying and decreased antral contractility in normal premenopausal women compared with men. Am J Gastroenterol. 1997;92:968-975.

Kumar D. In vitro inhibitory effect of progesterone on extrauterine human smooth muscle. Am J Obstet Gynecol. 1962;84:1300-1304.

Hutson WR, Roehrkasse RL, Wald A. Influence of gender and menopause on gastric emptying and motility. Gastroenterology. 1989;96:11-17.

Kao CH, Lai TL, Wang SJ. Influence of age on gastric emptying in healthy chinese. Clin Nucl Med. 1994;19:401-404.

Urbain JLC, Vekemans MC, Bouillon R. Characterization of gastric antral motility disturbances in diabetes using a scintigraphic technique. J Nucl Med. 1993;4:578-581.

Kong M F, Horowitz M. Diabetic gastroparesis. Diabet Med. 2005;22:3-18.

Minami H, McCallum RW. The physiology and pathophysiology of gastric emptying in humans. Gastroenterology. 1984;86:1592-1610.

Urbain JLC, Charkes ND. Recent advances in gastric emptying scintigraphy. Seminars Nucl Med. 1995;25:318-325.

Fried M. Methods to study gastric emptying. Dig Dis Sci. 1994;39(^ssuppl):114S-115S.

Milito G, Taccone-Gallucci M, Brancaleone C. Assessment of the upper gastrointestinal tract in hemodialisys patients awaiting renal transplantation. Am J Gastroenterol. 1983;78:328-331.

de Schoenmakere G, Vanholder R, Rottey S. Relationship between gastric emptying and clinical and biochemical factors in chronic haemodialysis patients. Nephrol Dial Transplant. 2001;16:1850-1855.

Adachi H, Kamiya T, Hirako M. Improvement of gastric motility by hemodialysis in patients with chronic renal failure. J Smooth Muscle Res. 2007;43:179-189.

Kao CH, Hsu Y, Wang SJ. Delayed gastric emptying and Helicobacter pylori infection in patients with chronic renal failure. Eur J Nucl Med. 1995;22:1282-1291.

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