MORPHOLOGY, DIPEPTIDASES AND DISACCHARIDASES OF SMALL INTESTINAL MUCOSA IN CHRONIC RENAL FAILURE

Abstract. The function of the small intestine has been studied in 29 patients with chronic renal failure (CRF). Small intestinal biopsies were taken from 19 patients (11 haemodialysis (HD), 6 uraemic and 2 nephrotic syndrome patients) and studied histologically and en‐zymatically (disaccharidases and dipeptidases). In half of these patients morphological changes in the form of elongation of the crypts and invasion of plasma cells were found: 14 had decreased sucrase and maltase activities, 10 low glycyl‐L‐leucine and L‐alanyl‐L‐proline dipeptidase activities, only 2 had normal enzyme activities, 10 low glycyl‐L‐leucine and L‐alanyl‐L‐proline the uraemic patients. Pancreatic function, tested in 5 patients, was normal. Increased faecal fat excretion was found in 4 of 14, low serum folate in 8 of 20 (before dialysis), and a flat blood glucose curve was usually found in the peroral glucose tolerance test. All these findings signify that a disturbed function of the small intestine is not uncommon in patients with CRF. This may be of importance when interpreting symptoms from the gut, especially when a carbohydrate‐rich diet is given.