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Type of manuscript：L etter to the editor
Manuscript title：
The Prevalence of Gallbladder Stones in Patients Receiving
Hemodialysis
Authors' full names: Kuan-Fu Liao, MD1,2
Hsiao-Yin Huang, MD3,4
Shih-Wei Lai, MD 3,4
(The first two authors contributed equally to this study)
1Division of Gastroenterology and Hepatology, Department of Internal Medicine,
Buddhist Tzu Chi General Hospital Taichung Branch, Taichung, 427, Taiwan
2School of Medicine, Tzu Chi University, Hualien, 970, Taiwan
3School of Medicine, China Medical University, Taichung 404, Taiwan
4 Department of Family Medicine, China Medical University Hospital, Taichung 404,
Taiwan
Address for Correspondence: Dr. Shih-Wei Lai, Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan
E-mail: [email protected] TEL: 886-4-2206-2121 ext. 4507 FAX: 886-4-2203-3986
Dear editor,
There is little evidence on the relationship between gallbladder stones and hemodialysis in Taiwan. A hospital-based, cross-sectional study was designed to analyze 167 patients with end-stage renal disease (83 men and 84 women, mean age
54.7 10.9 years, range from 19-70) receiving regular hemodialysis at one medical center located at Taichung in Taiwan during June of 2004. In addition, 167 age-sex matched subjects, who received private health checkups at the same medical center in
2007 and who had an estimated glomerular filtration rate more than 90mL/min per 1.73 m2, were selected to serve as the control group.
The prevalence of gallbladder stones was 18% in the hemodialysis group and 9.6% in the control group; the difference was statistically significant (p = 0.039). In addition, there was a statistically significant difference in mean age between subjects with and without gallbladder stones (59.3 vs. 53.4 years, p = 0.0004). Only the significantly related factors for gallbladder stones found in the univariate analysis were used for further analysis. After controlling for age and gender, a multivariate logistic
regression analysis showed that hemodialysis was associated with gallbladder stones (OR= 1.98, 95% CI= 1.02-3.85, p < 0.05).
In a previous study , the prevalence of gallbladder stones was higher in a group with chronic kidney disease not receiving hemodialysis than that in a control group (13.1% vs.4.9%, p <0.001). A study by Kazama et al in Japan , the prevalence of gallstones was not only higher in the chronic kidney disease group without receiving hemodialysis, but also increased with progression of chronic kidney disease stage (from 7.7% to 21.3%). This present study showed that patients with end-stage renal disease receiving regular hemodialysis had a greater prevalence of gallbladder stones, which was compatible with the study by Hahm et al in Korea (18.2% with
hemodialysis vs.5.3% in the control group) .
Although the underlying mechanism of gallbladder stone formation remains
unclear, the findings of this study suggest that patients with end-stage renal disease receiving regular hemodialysis is associated with gallbladder stones.
Reference
1. Lai SW, Liao KF, Lai HC et al. The prevalence of gallbladder stones is higher among patients with chronic kidney disease in Taiwan. Medicine (Baltimore) 2009; 88: 46-51.
2. 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. Nephron Clinical Practice 2009; 111: c167-c172.
3. Hahm JS, Lee HL, Park JY et al. Prevalence of gallstone disease in patients with end-stage renal disease treated with hemodialysis in Korea. Hepatogastroenterology 2003; 50: 1792-1795.
