Enterochromaffin cell density in the gastric mucosa of patients with chronic renal failure

Thirty patients with chronic renal failure (CRF) and 30 age- and sex-matched controls were assessed for gastrointestinal diseases by gastroscopy, serum gastrin determination, and routine clinical and laboratory evaluation. Biopsy specimens from their gastric oxyntic mucosa were immunohistochemically stained with monoclonal antibodies against serotonin (5-hydroxytryptamine) and chromogranin A, the latter staining all gastric endocrine cells, the former disclosing serotonin-containing enterochromaffin (EC) cells only. The average EC cell density (cells/mm(2)) in the CRF patients was significantly lower than in the controls: 2.6 vs 12.9 (p=0.0005). The EC cell counts also correlated negatively with serum gastrin values (p=0.0031). The densities of the chromogranin-positive cells did not differ between CRF patients (74 cells/mm(2)) and controls (76 cells/mm(2)) (p=0.7559). We conclude that, in addition to the previously known findings of hypoacidity, persistent hypergastrinaemia, and G and parietal cell hyperplasia, CRF also reduces the number of oxyntic EC cells. The negative correlation between EC cell density and serum gastrin levels reflects the complex interplay between different endocrinological activities in the gastrointestinal tract.