The Japanese Journal of Clinical Dialysis Vol.18 No.12(2-3-1)

Theme Gastrointestinal Complications in Dialysis Patients
Title Uremic colitis
Publish Date 2002/11
Author Isao Aoyama Department of Clinical Preventive Medicine, Nagoya University Hospital
Author Toshimitsu Niwa Department of Clinical Preventive Medicine, Nagoya University Hospital
[ Summary ] Uremic colitis is confirmed by the presence of uremia induced intestinal lesions. It is characterized by mucosal edema, erosion, and hemorrhagic injury, occasionally leading to ulceration and necrosis. Alterations in intestinal microflora in uremic states, such as intestinal overgrowth of aerobic bacteria, may be involved in the initiation and progression of uremic colitis. Two possible ways have been proposed as the mechanisms underlying the development of uremic colitis (1) bacterial production of uremic toxins or precursors (ammonia, phenols, indoles, etc.) in the intestinal tract and (2) bacterial invasion into the intestinal mucosa at the uremic state. The treatment of uremic colitis is aimed at removing uremic toxins in the intestinal tract and to improving intestinal microflora. The former includes dialysis therapy, administration of oral adsorbent and/or lactulose, and a low-protein diet. The latter contains administration of a lactobacillus and dietary fiber.
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