[Are dialysis-patients a risk population for cholelithiasis? Study in an apulian population]

The cholelithiasis (CL) has a 10-20% prevalence in the adult population. The end stage renal disease and dialysis would seem factors of risk since uremic patients show increased bile cholesterol, increased saturation indices and lithogenicity. Nevertheless the studies to confirm this hypothesis have furnished contradictory results. The aim of the study was to appraise prevalence of CL in dialysis-patients.

The authors examined 127 patients (92 in hemodialysis and 35 in peritoneal dialysis) comparing them with a non-uremic control group (CNU) and the prevalence in the general population taking as champion the town of Castellana, near to ''S. Maria Degli Angeli'' Hospital, where, previously, an epidemiological study was performed. Sonographic examination was done with Esaote/Biomedica AU3 instrument with 3.5/5 mHz transducer. The evidence of gallstone(s) by ultrasonography or previously cholecystectomy have been considered diagnostics.

Gallstones were detected in 33 of the 127 dialysis-patients (25.9% prevalence). In the CNU the prevalence was 15% (P=0.046). Furthermore the comparison of prevalence of CL between dialysis-patients and the Castellana population was greater in dialysis-population considering the attended rate (13 vs 9.6) and had a greater attributable risk (35%). A global greater prevalence of CL in older patients (>60 years) showed a possible role of the increasing age as a correlated factor to the CL. Any other considered parameter has shown significant correlations.

These results underline a greater risk of CL in the dialysis-patient.