Increased Risk of Cholelithiasis in Patients After Renal Transplantation With Respect to Dialysis Period

There is no consensus on the incidence and management of cholelithiasis (Cl) in renal transplant recipients (RTrs). In this study, we assessed Cl and its complications in RTrs before and after transplantation by abdominal ultrasonography in the same patients.

Body mass index, serum biochemistry, abdominal ultrasonography and complications of Cl were evaluated before and after transplantation. Also, duration of end stage renal disease, renal transplantation and immunosupressive drugs were evaluated. A total of 53 patients (M/F; 31/22) were evaluated and the mean age of the patients was 34.11±9.42 years. Before transplantation, 47 of 53 patients were on hemodialysis. The duration of hemodialysis, peritoneal dialysis and transplantation were 2.20±1.97, 1.32±0.74 years and 44.72±33.68 months, respectively. Before transplantation, one patient (1.9%); and after transplantation, 6 patients (11.3%) had Cl. None of the patients had history of cholecystectomy before transplantation and one patient had cholecystectomy due to pancreatitis after transplantation. Five of 6 patients who have Cl were on cyclosporine therapy and one patient was on tacrolimus therapy. Before and after transplantation, total cholesterol (p=0.043), HDL-cholesterol (p=0.000), calcium (0.045), body mass index (p=0.007) were significantly different from each other and borderline differences for Cl before and after transplantation.

In summary, the incidence of Cl increased from 1.9% to 11.3% in RTrs, complication of Cl was detected only in one patient. The incidence of Cl is higher in RTrs than pre-transplant patients. Our study was different from the others because pre- and post-transplant patients were the same patients. The most important factors for development of Cl were the usage of cyclosporine and exposed time of cyclosporine.