title: Acute cholecystitis in end-stage renal disease patients: a nation-wide longitudinal study.
abstract: BACKGROUND
  The objective of this study was to evaluate the risks of acute cholecystitis among end-stage renal disease patients and compare the incidence between two dialysis modality.
  
  
  METHODS
  In this retrospective cohort study, records of fifty thousand end-stage renal disease patients older than 20 years of age from 1998 to 2007 and an age, gender, Charlson's score, diabetes, and dyslipidemia matched control cohort were retrieved from Taiwan National Health Insurance Research Database. Hospitalizations for acute cholecystitis were retrieved using ICD-9-CM diagnosis codes and ICD-9-CM operation codes from in-patient claims.
  
  
  RESULTS
  The incidence rates were 5.8 per 1000 patient-years in the end-stage renal disease patients and 0.92 per 1000 patient-years in the control group. End-stage renal disease was an independent risk factor for acute cholecystitis. In the end-stage renal disease patients, independent risk factors were old age, higher Charlson's score, diabetes, severe liver disease, atrial fibrillation, and haemodialysis (all p<0.05). However, the peritoneal dialysis patients had a higher mortality rate after developing acute cholecystitis.
  
  
  CONCLUSIONS
  Acute cholecystitis is not uncommon in end-stage renal disease patients. The independent risk factors were older age, higher Charlson's score, atrial fibrillation, severe liver disease, diabetes, and dialysis modality. Haemodialysis patients had a higher risk of acute cholecystitis than PD patients.
authors.affiliation: Department of Medicine, Taipei City Hospital Heping Fuyou Branch, Taipei, Taiwan.
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.forename: Shuo-Ming
authors.initials: SM
authors.lastname: Ou
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Chao
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Lung-Wen
authors.initials: LW
authors.lastname: Tsai
authors.forename: Tzen-Wen
authors.initials: TW
authors.lastname: Chen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D041881:Cholecystitis, Acute / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology