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Renal Transplant Alıcılarınd a Diyaliz Dönemine Göre Safra Kesesi Taşı Riskinde Artış

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

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
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 ultrasonog-raphy 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 transplantati¬on, one patient (1.9%); and after transplantation, 6 patients (11.3%) had Cl. None of the patients had history of cholecystectomy befo¬re 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 inciden¬ce 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.
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Abstract (Original Language): 
Renal transplantasyo n sonrası safra kesesi taşı sıklığı ve tedavisinde görüş birliği yoktur. Bu çalışmada, aynı hasta grubunda renal transplantasyon öncesi ve sonrası safra kesesi taşı ve kompli-kasyonlarını batın ultrasonografisi ile değerlendirdik. Elli üç renal transplant alıcısında transplantasyon öncesi ve sonrasında vücut kitle indeksi, serum biyokimya değerleri, batın ult-rasonografisi ve safra kesesi taşı komplikasyonları değerlendirildi. Aynı zamanda son dönem böbrek yetersizliği ve renal transplantasyon süresi ile birlikte kullanılan immünosüpresif ilaçlar kayıt edildi. Toplam 53 olgu (E/K; 31/22) değerlendirildi ve olguların ortalama yaşları 34.11±9.42 yıl idi. Renal transplantasyon öncesi 47 hasta hemodiyaliz tedavisinde idi. Sırası ile hemodiyaliz, peritoneal diyaliz ve transplantasyon süreleri 2.20±1.97 yıl, 1.32±0.74 yıl ve 44.72±33.68 ay idi. Transplantasyon öncesi 1 (%1.9) ve transplantasyon sonrası 6 olguda (%11.3) safra kesesi taşı saptandı. Olguların hiçbirinde transplantasyon öncesi kolesistektomi öyküsü yok iken transplantasyon sonrası bir olguya pankreatit nedeni ile kolesistek-tomi uygulandı. Transplantasyon sonrasında safra kesesi taşı olan 6 olgunun beşi siklosporin, biri takrolimus kullanıyordu. Transplantasyon öncesi ve sonrasında, total kolesterol (p=0,043), HDL-koles-terol (p=0,000), kalsiyum (0,045), vücut kitle indeksi (p=0,007) değerleri farklı idi ve safra kesesi taşı için sınırda farklılık vardı. Özet olarak, safra kesesi taşı sıklığı transplantasyon sonrası %1.9'dan %11.3'e yükseldi ve bir olguda safra kesesi taşı ile ilişkili komplikasyon saptandı. Diğer çalışmalardan farklı olarak çalışma¬mızda, transplantasyon öncesi ve sonrasında aynı hastalar değer¬lendirilmiş olup safra kesesi taşı gelişiminde siklosporin kullanımı ve kullanım süresi en önemli faktör olarak bulunmuştur.
FULL TEXT (PDF): 
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  • 2
76-79
  • Turkish

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