Effects of omeprazole therapy on peptic disease and serum gastrin levels in hemodialysis patients. A preliminary study.

Hemodialysis patients are frequently affected by peptic disease, and in many cases they have high serum levels of gastrin. The aim of this study was to evaluate the effects of omeprazole, an inhibitor of gastric parietal cells hydrogen pump, on peptic disease and gastric secretion of 16 selected dialysis patients. H2-receptors blocking drugs or gastric acidity buffers were withdrawn for 2 weeks, then omeprazole was administered for 4 weeks at a daily dosage of 20 mg. Before and after the omeprazole therapy, registration of subjective peptic symptoms, baseline serum gastrin dosage and endoscopy of upper digestive tract were performed. Before starting omeprazole, the serum gastrin value was 515 +/- 180 pg/l, all the patients complained of peptic symptoms, and endoscopy showed: 8 cases of duodenal ulcer, 3 cases of pyloric ulcer and 5 cases of antral erosive gastritis. At the end of the omeprazole treatment period, a slight but statistically not significant increase of serum gastrin level (537 +/- 198 pg/l) was observed. Twelve patients reported the total disappearance of symptoms of peptic disease, 3 patients a partial reduction, and 1 patient had no improvement. Control endoscopy showed the healing (white scar) of all the ulcers, and the disappearance of all the erosive lesions. In conclusion, our results show that a 20 mg/day omeprazole short-term therapy can be given safely to uremic patients undergoing hemodialysis and is effective for a quick healing of active peptic lesions.