Asymptomatic gallstones and duration of cyclosporine use in kidney transplant recipients.
BACKGROUND
Cyclosporine (CsA) use has been associated to the development of cholelithiasis in transplant recipients. We herein explored the role of time under CsA on this association in asymptomatic adult kidney transplant recipients (KTR).


METHODS
A cross-sectional study was conducted in 140 KTR with variable post-transplant follow-up (PTFU), and without history of symptomatic biliary disease. Upper abdominal ultrasound was performed in all patients. According to the immunosuppressive schedule, patients were classified in three groups: Azathioprine + prednisone (group 1, n = 37), azathioprine + prednisone < 24 months CsA (group 2, n = 58), or azathioprine + prednisone > or = 24 months CsA (group 3, n = 45). Age at time of ultrasound performance, gender, PTFU, chronic viral liver disease, parity, oral contraceptives, serum lipids, diabetes and body mass index were analyzed concomitantly.


RESULTS
Median age was 38, 31, and 36 years in groups 1, 2, and 3, respectively. The male:female ratio in the same groups was 1.5:1, 1:1, and 2:1. Mean PTFU was 130, 48, and 53 months, respectively (p = 0.0001). Gallstones were found in three (8%) group 1 KTR, in nine (16%) group 2 KTR, and in 10 (22%) group 3 KTR (p = 0.214). Adjusting for PTFU, the association between length of CsA and prevalence of lithiasis was significantly stronger among those with longer use of CsA (odds ratio = 6.1, p = 0.046). No significant differences were found among groups in the other variables.


CONCLUSIONS
KTR receiving CsA for more than two years show increased prevalence of gallstones.
Alberú
J
J
Gatica
M
M
Cachafeiro-Vilar
M
M
Robles-Díaz
G
G
Bezaury
P
P
Paz-Pinedo
F
F
Vargas-Vorácková
F
F
D001379:Azathioprine / Q000627:therapeutic use; D001646:Bile / Q000378:metabolism; D002769:Cholelithiasis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003276:Contraceptives, Oral / Q000009:adverse effects; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006525:Hepatitis, Viral, Human / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D016030:Kidney Transplantation; D008800:Mexico / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D010298:Parity; D011241:Prednisone / Q000627:therapeutic use; D015995:Prevalence; D013997:Time Factors; D014463:Ultrasonography
D003276:Contraceptives, Oral; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone