title: Long-term use of fenofibrate is associated with increased prevalence of gallstone disease among patients undergoing maintenance hemodialysis.
abstract: BACKGROUND
  In spite of insufficient evidence to guide the use of lipid-lowering drugs (LLDs) among the dialysis population, these drugs are frequently used to treat dyslipidemia. Several studies have found that long-term use of LLDs is associated with an increased risk of gallstone disease (GSD) in the general population. However, the lithogenic risk of LLDs in patients undergoing hemodialysis (HD) has not been studied.
  
  
  OBJECTIVE
  It is to assess the influence of long-term use of LLDs on the prevalence of GSD among patients undergoing HD.
  
  
  METHODS
  This cross-sectional study included 108 eligible patients receiving maintenance HD: 35 receiving lovastatin; 34 fenofibrate; and 39 no LLD. GSD was defined as the presence of gallstones or the performance of cholecystectomy while taking LLD. Abdominal ultrasonography, demographic parameters, and laboratory data were obtained for all enrolled subjects. ANOVA with Bonferroni's test and chi-square test were used to compare differences among the three groups.
  
  
  RESULTS
  The three groups had similar clinical characteristics with regard to age, gender, duration of HD, body mass index, and total cholesterol values. However, a significantly higher prevalence of GSD and higher triglyceride levels were found in patients receiving fenofibrate, compared with those in other groups (p < 0.05). Among dialysis patients on fenofibrate, increased age, female gender, larger daily dose, and longer duration of treatment were associated with increased risks for GSD.
  
  
  CONCLUSIONS
  Our study shows that long-term use of fenofibrate is related to increased risk of GSD among HD patients. Further large-scale studies are needed to confirm our findings.
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Huey-Liang
authors.initials: HL
authors.lastname: Kuo
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Yeh
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Hsu
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D011345:Fenofibrate / Q000009:adverse effects*; D042882:Gallstones / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008148:Lovastatin / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000960:Hypolipidemic Agents; D008148:Lovastatin; D011345:Fenofibrate