The Prevalence and Risk Factors of Gallbladder Stone in Dialysis Patients_West China Medical Journal

Authors：

 ZHANGYan-ling ^1,2 , ZHANGLie-mei ¹ , LIUYa ¹ ,  TANGXiao-hong ¹

1. 绵阳市第三人民医院肾内科;
2. Department of Nephiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

TANGXiao-hong, Email: xhtng@126.com

Keywords：

Hemodialysis; Peritoneal dialysis; Gallbladder stone

DOI：

10.7507/1002-0179.20140005

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Objective To investigate the prevalence of gallbladder stone in dialysis patients, determine whether it is higher than that in the general population, find out the difference of prevalence between hemodialysis and peritoneal dialysis patients, and analyzes the possible causes. Methods We analyzed the prevalence of gallbladder stone in 358 dialysis patients (126 cases of hemodialysis and 232 cases of peritoneal dialysis) followed up in our hospital from January 2009 to October 2012. And we compared it with 376 patients diagnosed with chronic kidney disease stage 5 (CKD5) and the general population. Results The prevalence of gallbladder stone in dialysis patients followed up in our hospital was 23.5%, which was higher than CKD5 patients (P=0.002). The prevalence was significantly greater in dialysis patients than that in the general population (P<0.000 5). In the dialysis patients who were younger than sixty years old, the prevalence of gallbladder stone in peritoneal dialysis patients was obviously higher than that in the hemodialysis patients (P<0.05). The albumin level was significantly lower in peritoneal dialysis patients than in the hemodialysis patients. At the same time, cholesterol, low density lipoprotein, and the ratio of low density lipoprotein to high density lipoprotein were much higher with statistical significance. Logistic regression analysis showed that increasing age (OR=2.581, P=0.001), female (OR=2.554, P=0.000), the primary disease (diabetes mellitus) (OR=1.947, P=0.044) and dialysis period (OR=1.000, P=0.006) were risk factors for gallbladder stone in dialysis patients. Conclusion The prevalence of gallbladder stone in dialysis patients is higher than that in the general population. Peritoneal dialysis patients have more risk factors to get gallbladder stone than hemodialysis patients. Risk factors for gallbladder stone in dialysis patients are increasing age, female, primary disease (diabetes mellitus), dyslipidemia, hypoalbuminemia, long dialysis period and so on.

Citation： ZHANGYan-ling, ZHANGLie-mei, LIUYa, TANGXiao-hong. The Prevalence and Risk Factors of Gallbladder Stone in Dialysis Patients. West China Medical Journal, 2014, 29(1): 15-18. doi: 10.7507/1002-0179.20140005 Copy

1.	Balzer K, Goebell H, Breuer N, et al. Epidemiology of gallstones in a German industrial town (Essen) from 1940-1975[J]. Digestion, 1986, 33(4):189-197.
2.	Maurer KR, Everhart JE, Ezzati TM, et al. Prevalence of gallstone disease in Hispanic populations in the United States[J]. Gastroenterology, 1989, 96(2 Pt 1):487-492.
3.	Thijs C, Knipschild P, van Engelshoven J. The prevalence of gallstone disease in a Dutch population[J]. Scand J Gastroenterol, 1990, 25(2):155-160.
4.	裘法祖. 外科学[M]. 3版. 北京:人民卫生出版社, 1991:536-536.
5.	赵元全, 陈希宁, 朱顺琴, 等. 胆结石患病趋势研究[J]. 现代预防医学, 2002, 29(1):14-15.
6.	Li Vecchi M, Cesare S, Soresi M, et al. Prevalence of biliary lithiasis in a sicilian population of hemodialysis patients[J]. Clin Nephrol, 2001, 55(2):127-132.
7.	Badalamenti S, DeFazio C, Castelnovo C, et al. High prevalence of silent gallstone disease in dialysis patents[J]. Nephron, 1994, 66(2):225-227.
8.	Hojs R. Cholecystolithiasis in patients with end-stage renal disease treated with hemodialysis:a study of prevalence[J]. Am J Nephrol, 1995, 15(1):15-17.
9.	Kazama JJ, Kazama S, Koda R, et al. The risk of gallbladder stone formation is increased in patients with predialysis chronic kidney disease but not those undergoing chronic hemodialysis therapy[J]. Nephron Clin Pract, 2009, 111(3):c167-c172.
10.	Gernone G, Detomaso F, La Rosa R, et al. Are dialysis-patients a risk population for cholelithiasis? Study in an apulian population[J]. Minerva Urol Nefrol, 2009, 61(1):21-26.
11.	Altiparmak MR, Pamuk ON, Pamuk GE, et al. Incidence of gallstones in chronic renal failure patients undergoing hemodialysis:experience of a center in Turkey[J]. Am J Gastroenterol, 2003, 98(4):813-820.
12.	Korzets Z, Golan E, Ben-Chirit S, et al. Prevalence of cholelithiasis in non-diabetic haemodialysis and continuous ambulatory peritoneal dialysis patients[J]. Nephron, 1998, 78(1):44-47.
13.	Nakeeb A, Comuzzie AG, Martin L, et al. Gallstones:genetics versus environment[J]. Ann Surg, 2002, 235(6):842-849.
14.	Bates T, Harrison M, Lowe D, et al. Longitudinal study of gallstone prevalence at necropsy[J]. Gut, 1992, 33(1):103-107.
15.	Hahm JS, Lee HL, Park JY, et al. Prevalence of gallstone disease in patients with end-stage renal disease treated with hemodialysis in korea[J]. Hepatogastroenterology, 2003, 50(54):1792-1795.
16.	Nilsson S. Gallbladder disease and sex hormones. A statistical study[J]. Acta Chir Scand, 1966, 132(3):275-279.
17.	Kikkawa R, Koya D, Haneda M. Progression of diabetic nephropathy[J]. Am J Kindey Dis, 2003, 41(3 Suppl 1):S19-21.
18.	Marschall HU, Einarsson C. Gallstone disease[J]. J Intern Med, 2007, 261(6):529-542.
19.	Fraquelli M, Pagliarulo M, Colucci A, et al. Gallbladder motility in obesity, diabetes mellitus and coeliac disease[J]. Dig Liver Dis, 2003, 35(Suppl 3):S12-S16.
20.	Misciagna G, Guerra V, di Leo A, et al. Insulin and gall stones:a population case control study in southern Italy[J]. Gut, 2000, 47(1):144-147.
21.	Muntner P, Coresh J, Smith JC, et al. Plasma lipids and risk of developing renal dysfunction:the atherosclerosis risk in communities study[J]. Kidney Int, 2000, 58(1):293-301.
22.	Villalon I, Tuchweben B, Yousef IM. Effect of a low protein diet on bile flow and composition rats[J]. J Nutr, 1987, 17(4):678-683.
23.	Shurraw S, Tonelli M. Statins for treatment of dyslipidemia in chronic kidney disease[J]. Perit Dial Int, 2006, 26(5):523-539.

1. Balzer K, Goebell H, Breuer N, et al. Epidemiology of gallstones in a German industrial town (Essen) from 1940-1975[J]. Digestion, 1986, 33(4):189-197.
2. Maurer KR, Everhart JE, Ezzati TM, et al. Prevalence of gallstone disease in Hispanic populations in the United States[J]. Gastroenterology, 1989, 96(2 Pt 1):487-492.
3. Thijs C, Knipschild P, van Engelshoven J. The prevalence of gallstone disease in a Dutch population[J]. Scand J Gastroenterol, 1990, 25(2):155-160.
4. 裘法祖. 外科学[M]. 3版. 北京:人民卫生出版社, 1991:536-536.
5. 赵元全, 陈希宁, 朱顺琴, 等. 胆结石患病趋势研究[J]. 现代预防医学, 2002, 29(1):14-15.
6. Li Vecchi M, Cesare S, Soresi M, et al. Prevalence of biliary lithiasis in a sicilian population of hemodialysis patients[J]. Clin Nephrol, 2001, 55(2):127-132.
7. Badalamenti S, DeFazio C, Castelnovo C, et al. High prevalence of silent gallstone disease in dialysis patents[J]. Nephron, 1994, 66(2):225-227.
8. Hojs R. Cholecystolithiasis in patients with end-stage renal disease treated with hemodialysis:a study of prevalence[J]. Am J Nephrol, 1995, 15(1):15-17.
9. Kazama JJ, Kazama S, Koda R, et al. The risk of gallbladder stone formation is increased in patients with predialysis chronic kidney disease but not those undergoing chronic hemodialysis therapy[J]. Nephron Clin Pract, 2009, 111(3):c167-c172.
10. Gernone G, Detomaso F, La Rosa R, et al. Are dialysis-patients a risk population for cholelithiasis? Study in an apulian population[J]. Minerva Urol Nefrol, 2009, 61(1):21-26.
11. Altiparmak MR, Pamuk ON, Pamuk GE, et al. Incidence of gallstones in chronic renal failure patients undergoing hemodialysis:experience of a center in Turkey[J]. Am J Gastroenterol, 2003, 98(4):813-820.
12. Korzets Z, Golan E, Ben-Chirit S, et al. Prevalence of cholelithiasis in non-diabetic haemodialysis and continuous ambulatory peritoneal dialysis patients[J]. Nephron, 1998, 78(1):44-47.
13. Nakeeb A, Comuzzie AG, Martin L, et al. Gallstones:genetics versus environment[J]. Ann Surg, 2002, 235(6):842-849.
14. Bates T, Harrison M, Lowe D, et al. Longitudinal study of gallstone prevalence at necropsy[J]. Gut, 1992, 33(1):103-107.
15. Hahm JS, Lee HL, Park JY, et al. Prevalence of gallstone disease in patients with end-stage renal disease treated with hemodialysis in korea[J]. Hepatogastroenterology, 2003, 50(54):1792-1795.
16. Nilsson S. Gallbladder disease and sex hormones. A statistical study[J]. Acta Chir Scand, 1966, 132(3):275-279.
17. Kikkawa R, Koya D, Haneda M. Progression of diabetic nephropathy[J]. Am J Kindey Dis, 2003, 41(3 Suppl 1):S19-21.
18. Marschall HU, Einarsson C. Gallstone disease[J]. J Intern Med, 2007, 261(6):529-542.
19. Fraquelli M, Pagliarulo M, Colucci A, et al. Gallbladder motility in obesity, diabetes mellitus and coeliac disease[J]. Dig Liver Dis, 2003, 35(Suppl 3):S12-S16.
20. Misciagna G, Guerra V, di Leo A, et al. Insulin and gall stones:a population case control study in southern Italy[J]. Gut, 2000, 47(1):144-147.
21. Muntner P, Coresh J, Smith JC, et al. Plasma lipids and risk of developing renal dysfunction:the atherosclerosis risk in communities study[J]. Kidney Int, 2000, 58(1):293-301.
22. Villalon I, Tuchweben B, Yousef IM. Effect of a low protein diet on bile flow and composition rats[J]. J Nutr, 1987, 17(4):678-683.
23. Shurraw S, Tonelli M. Statins for treatment of dyslipidemia in chronic kidney disease[J]. Perit Dial Int, 2006, 26(5):523-539.

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