Esophageal Dysmotility in Chronic Hemodialysis Patients After Ingestion of Liquids With Different Viscosities

BACKGROUND Previous studies assessing esophageal motility in chronic renal failure (CRF) patients had no consistency in their findings. These studies evaluated esophageal contractility in response to dry/water swallows. Our aim was to reassess esophageal motility in CRF patients to better define its abnormalities. To unmask minor defects not seen in conventional dry/water manometry we also evaluated esophageal contractility in response to a highly viscous substance. METHODS Fifteen controls and nine asymptomatic CRF patients underwent esophageal manometry with dry swallows, swallows of 5 mL of water (1 centipoise) and 5 mL of sugar cane syrup (24500 centipoise). CRF patients were compared with controls for esophageal motility parameters, considering each type of swallow (dry/water/syrup). RESULTS CRF patients had: tendency for higher lower esophageal sphincter (LES) resting pressure (P = 0.09); shorter LES relaxation duration after dry/water/syrup swallows (P = 0.0001, P < 0.0001, P = 0.0001, respectively); higher amplitude of proximal contractions after dry/water/syrup swallows (P = 0.008, P = 0.01, P = 0.04); tendency for longer duration of distal contractions after dry/water/syrup swallows (P = 0.07, P = 0.04, P = 0.09); lower velocity of distal contractions after dry/water/syrup swallows (P = 0.006, P = 0.09, P = 0.02); and higher incidence of multi-peaked contractions after dry/water/syrup swallows (P = 0.03, P = 0.0001, P < 0.0001). CONCLUSIONS Esophageal motility dysfunction can be a sub-clinical manifestation in CRF patients. Data also showed that swallows of a highly viscous liquid did not help to detect minor esophageal dysmotility in these patients.