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

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          Abstract

          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

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1995
          1995
          18 December 2008
          : 70
          : 3
          : 296-300
          Affiliations
          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
          Article
          188607 Nephron 1995;70:296–300
          10.1159/000188607
          7477616
          © 1995 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Original Paper

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