{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:38:30Z","timestamp":1791308310011,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T00:00:00Z","timestamp":1487635200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Chronic kidney disease (CKD) affects gastrointestinal (GI) function and results in numerous adaptive and maladaptive responses. Disruption of the colonic microbiome and its attendant consequences\u2014the loss of gut barrier integrity and increased generation of uremic toxins\u2014has become well\u2010recognized. However, less attention has been paid to characterizing the mechanisms behind dysfunction of the upper GI tract, largely owing to the difficulty of studying small bowel function <jats:italic>in vivo<\/jats:italic>. This present study was designed to comprehensively describe upper GI function in those with advanced renal impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010five non\u2010diabetic subjects (12 CKD stage 4\/5 patients, 23 healthy controls) underwent detailed GI magnetic resonance imaging (MRI) in both fasted and fed states. Upper GI function was assessed by quantification of gastric emptying and intra\u2010luminal small bowel water. Characterization of hydration and cardiovascular status was performed at baseline. Gut barrier integrity was assessed using serum endotoxin level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Chronic kidney disease was associated with dysmotility (gastric half\u2010emptying time 96\u2009\u00b1\u200932 <jats:italic>vs<\/jats:italic> 74\u2009\u00b1\u200927\u2009min, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and reduced fasting and post\u2010prandial small bowel water (36\u2009\u00b1\u200922\u2009mL <jats:italic>vs<\/jats:italic> 78\u2009\u00b1\u200942\u2009mL, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), reflecting abnormal digestive secretion, and absorption. This was related to the degree of endotoxemia (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.60, <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and poorer symptom scores, but not to disease severity, arterial stiffness or hydration status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chronic kidney disease adversely affects digestive function. Abnormalities in digestive secretion and absorption may potentially have a broad impact in the prevention and treatment of both CKD and its complications. Further study is required to assess the factors that contribute to this dysfunction in a wider CKD population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13458","type":"journal-article","created":{"date-parts":[[2016,5,25]],"date-time":"2016-05-25T06:57:54Z","timestamp":1464159474000},"page":"372-377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Patients with chronic kidney disease have abnormal upper gastro\u2010intestinal tract digestive function: A study of uremic enteropathy"],"prefix":"10.1111","volume":"32","author":[{"given":"Claire J","family":"Grant","sequence":"first","affiliation":[{"name":"The Lilibeth Caberto Kidney Clinical Research Unit  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Royal Derby Hospital  Derby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline L","family":"Hoad","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Imaging Centre University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Marciani","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny A","family":"Gowland","sequence":"additional","affiliation":[{"name":"Sir Peter Mansfield Imaging Centre University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W","family":"McIntyre","sequence":"additional","affiliation":[{"name":"The Lilibeth Caberto Kidney Clinical Research Unit  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013080905"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu287"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05910809"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2005.05.010"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1681\/ASN.V641313","article-title":"Effect of chronic experimental renal insufficiency on urate metabolism","volume":"6","author":"Vaziri N","year":"1995","journal-title":"J. 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