IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 9 Ser.1 (September. 2020), PP 10-14 www.iosrjournals.org DOI: 10.9790/0853-1909011014 www.iosrjournal.org 10 | Page CKD-A risk factor for cholelithiasis: An observational study at a tertiary teaching hospital in Jharkhand Dr.Shiv Shankar Munda 1 , Dr.Sanjay Singh 2 , Dr.Sita Paikra 3* , Dr.RishiTuhin Guria 4 1 Junior resident, Department of Medicine, Rajendra Institute of Medical Sciences,Ranchi,,Jharkhand 2 Professor, Department of Medicine, Rajendra Institute of Medical Sciences,Ranchi,Jharkhand 3 Junior resident, Department of Medicine, Rajendra Institute of Medical Sciences,Ranchi,,Jharkhand 4 Associate Professor, Department of Medicine, Rajendra Institute of Medical Sciences,Ranchi,Jharkhand *Corresponding author-Dr.Sita Paikra Abstract Objective- The study was done to see the prevalence of cholelithiasis in chronic kidney disease(CKD) patients and establish CKD as a risk factor for cholelithiasis. Materials and method- Medical, demographic and clinical data of all the patients were recorded between age of 18-70 years with diagnosis of CKD as per NFK/KDOQI criteria regardless of its primary cause.The serum creatinine and blood urea was estimated at the time of admission and eGFR was calculated. USG abdomen was done during hospital stay. Results- Overall prevalence of cholelithiasis in CKD patients was 18.9%. Prevalence rate of cholelithiasis was increasing with age and body mass index(BMI), much higher in female, dyslipidemic, diabetic and patients with secondary hyperparathyroidism. Conclusion- CKD should be considered a risk factor for cholelithiasis. Identified modifiable risk factors like BMI, diabetes, dyslipidemia and secondary hyperparathyroidism warrant proper treatment to prevent the occurrence and progression of cholelithiasis. Keywords- CKD, Cholelithiasis, BMI, eGFR. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 20-08-2020 Date of Acceptance: 06-09-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Chronic Kidney Disease encompasses a spectrum of different pathophysiologic process associated with abnormal kidney function and a progressive decline in glomerular filtration rate (GFR)which is irreversible. 1 At least 6% of adult population in United States have CKD stage 1and 2, additional 4.5% is estimated to have stage 3 and 4 CKD 1 .SEEK ( Screening and Early Evaluation of Kidney Disease ) study in India revealed a prevalence rate of 17.2% CKD patients out of which 6% has CKD stage 3 or worse 2 . Cholelithiasis is the formation of stone in gall bladder. NHANES III survey in United States has revealed an overall prevalence of 7.9% in men and 16.6% in women. 1 Patients with CKD may have a more complex disorder of gastrointestinal motility that contributes to gallbladder stasis, which is an important factor in gallbladder stone formation. Gallbladder motility is controlled by a complex process involving neural and hormonal factors 3,4 . Autonomic nervous system may become dysfunctional in the uremic state which controls gastrointestinal motility 5,6 .Serum level of cholecystokinin, gastrin, glucagon and some other hormonal factors involved in gastrointestinal motility are significantly higher in renal insufficiency. 7,8,9 The disproportionate increases of hormonal factors with antagonistic effects on gastrointestinal motility may alter gastrointestinal function. The aim of our study is study the prevalence of cholelithiasis in CKD patients and establish CKD as one of the risk factor for cholelithiasis. II. Materials And Method It was a hospital based prospective and observational study.Medical, demographic and clinical data of all the chronic kidney disease patients were recorded between age group of 18-70 years with diagnosis of CKD as per NFK/KDOQI criteria 10 regardless of its primary cause from 1 st September 2017 to 31 st August 2018.The serum creatinine and blood urea was estimated and eGFR was calculated.USG abdomen and other relevant blood investigations were done subsequently during hospital stay.