الفهرس 
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Abstract
Chronic kidney disease has many effects as: Glucose intolerance, hyperlipidemia, hyperuricemia, malnutrition, Hyperphosphatemia, metastatic calcification, secondary hyperparathyroidism, hypocalcemia, anorexia, nausea, vomiting gastroenteritis, GastroIntestinal bleeding, peptic ulcer.. Factors related to kidney disease may have overshadowed the classical risk factors seen in bilary stones.
This work isfocusing mainly on evaluation the prevalence of biliary lithiasis (BL) and associated risk factors in patients with chronic kidney disease (CKD) on conservative treatment,compared with patients withchronic kidney disease on regular haemodialysis (HD) in different centers of dialysis in Assiut city.
Subjects:
This research design included a study group and a control group.The study groupincluded 180 patients, their ages ranged from (33-75) years old with chronic kidney disease, was subdevided into two groups:
Group I: (120 cases) with chronic kidney disease on regular haemodialysis.
Group II: (60 cases) with chronic kidney disease on conservative treatment.
The control group consisted of40 normal subjects from both sexes their ages ranged from (40- 60) years all were volunteers from relatives of the patients attended to kidney dialysis unit and were free from chronic major illness.
Methodology: Each subject was submitted for:
1-Initial clinical sheet:Included name, age, sex, residence and educational level of the studied group. Also data about the clinical diagnosis, information about duration of illness, medical treatment and its duration and associated comorbid conditions.Body mass index (BMI) which is measured by body weight (in kg) divided by the square of the height (in m2). The formulas universally used in medicine produce a unit of measure of kg/m2 (Gadzik J.,2006).
2-Invesigations: including
• Blood Urea
• Serum Creatinine
• Lipid profile
o Cholesterol
o Triglycerides
• Serum calcium
• Abdominal Ultrasonography: an ultrasound scan of the gallbladder and biliary tract
- Regarding Group I (chronic kidney disease on regular haemodilaysis),all blood samples and ultrasound scan done for them before their session of regular dialysis.
Result:
The present study showed that chronic renal failure patients on haemodilaysis have a biliary stones prevalence(26.7%) that was higher than that of general population(15%)but lower than that of chronic Renal Failure patients on conservative treatment(41.7%).
There are metabolic changes that occurs as part of chronic kidney disease as hypocalcemia,hypertriglyceridemia and hypercholsterlemia in addition to low protein diet, all these changes may have role in the increased incidence of biliary stones in chronic Renal Failure patients.
Conclusion:
• Patients with chronic Renal Failure (either on haemodilaysis or on conservative treatment) have a higher prevalence of biliary stones than the general population from the same geographic region.Factors related to kidney disease may have overshadowed the classical risk factors seen in the general population.The use of low-protein diets, which are started at very early stages in chronic Renal Failure, may facilitate increasing biliary stone formation.
• Biochemical alterations in the serum calcium associated with the renal failure and dietary calcium supplementation play a central role in the formation of gallstones.Chronic renal disease is accompanied by abnormalities of lipid metabolism, in the form of hypercholestremia and hypertriglyceridemia and this may be the cause of increase prevalence of gall bladder stones in patients with CRF.