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      Gastroparesis in Diabetics on Chronic Dialysis: Clinical and Laboratory Associations and Predictive Features

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          Clinical and laboratory features and risk factors for diabetic gastroparesis (DGP) were investigated in 226 diabetics on chronic dialysis; 106 subjects (43%) had DGP diagnosed by persistent vomiting improved with the use of prokinetic agents and 120 (control group) had no clinical DGP. Type 1 diabetics had DGP more frequently than type 2 diabetics (70 vs. 37%). The DGP group had longer duration of diabetes (21 ± 8 vs. 13 ± 6 years), higher frequency of diabetic orthostatic hypotension (95 vs. 33%), enteropathy (49 vs. 5%), blindness (52 vs. 23%), myocardial infarction (86 vs. 42%), extremity gangrene (54 vs. 27%) and cerebrovascular accidents (43 vs. 25%), lower serum albumin 32.3 ± 3.9 vs. 35.4 ± 3.8 g/l), urea (24.0 ± 5.5 vs. 25.5 ± 5.5 mmol/l) and creatinine (710 ± 210 vs. 820 ± 220 μmol/l), and higher serum TCO<sub>2</sub> (20.9 ± 3.1 vs. 19.8 ± 2.7 mmol/l) than the control group (all differences significant at p ± 0.004). Glycemic control was adequate in 24% of the DGP group subjects and 83% of the control subjects (p < 0.001). Annual hospitalization rate was 49 ± 48 days/patient in the DGP group and 16 ± 27 days/patient in the control group (p < 0.001). Median patient survival was 24 ± 2 months in the DGP group and 61 ± 9 months in the control group (p < 0.0001). Logistic regression identified long duration of diabetes and poor glycemic control as risk factors for DGP. In diabetics on dialysis, DGP is associated with high frequency of other diabetic complications, low serum albumin and creatinine, and high morbidity and mortality. Efforts to improve glycemic control in the hope of delaying DGP appear to be worthwhile.

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          Author and article information

          S. Karger AG
          18 December 2008
          : 70
          : 3
          : 296-300
          aDepartment of Radiology, Virginia Mason Clinic, Seattle, Wash., and bAmbulatory Care Medicine and cRenal Section, Veterans Affairs Medical Center and dNephrology Division, University of New Mexico School of Medicine, Albuquerque, N. Mex., USA
          188607 Nephron 1995;70:296–300
          © 1995 S. Karger AG, Basel

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          Pages: 5
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