Chylous peritonitis in peritoneal dialysis

Authors

  • Hanen Abid Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Salma Toumi Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Hanen Chaker Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Beya Fandri Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Ikram Agrebi Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Najla Dammak Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Fatma Mseddi Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker, Sfax, Tunisie
  • Khawla Kammoun Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Soumaya Yaich Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie
  • Mohamed Ben Hmida Service de néphrologie, dialyse et transplantation rénale, CHU Hedi Chaker; Laboratoire de pathologie rénale Lr19es11, Faculté de médecine de Sfax, Sfax, Tunisie

DOI:

https://doi.org/10.25796/bdd.v4i3.62623

Keywords:

peritoneal dialysis, chylous peritonitis, calcium channel blocker, tuberculosis.

Abstract

Chylous peritonitis (CP) is a rare complication in patients on peritoneal dialysis. There are many reasons for this. It can occur as a result of a traumatic insertion of the peritoneal dialysis catheter or secondary to infectious or drug causes. The evolution is favorable at the elimination of the causative agent.

We report 3 cases of PC occurring in 3 patients on peritoneal dialysis. In 2 patients, CP was secondary to calcium channel blockers and in 1 case associated with lymph node tuberculosis. The cessation of the causative agent allowed a clarification of the effluent dialysate. CP is a mild form of non-infectious peritonitis that is often confused with infectious peritonitis. In this article we discuss the etiologies of CPs, the pathophysiology and the conduct to be held in front of a CP.

References

1. Cheung CK, Khwaja A. Chylous ascites: an unusual complication of peritoneal dialysis. A case report and literature review. Perit Dial Int. 2008;28(3):229‑31.
2. Kumar A, Mandavdhare HS, Rana SS, Gupta R, Sharma V. Chylous ascites due to idiopathic chronic pancreatitis managed with endoscopic stenting. Clin Res Hepatol Gastroenterol. 2018;42(2):e29‑31.
3. Lizaola B, Bonder A, Trivedi HD, Tapper EB, Cardenas A. the diagnostic approach and current management of chylous ascites. Aliment Pharmacol Ther. 2017;46(9):816‑24.
4. Pomeranz A, Reichenberg Y, Schurr D, Drukker A. Chyloperitoneum: A Rare Complication of Peritoneal Dialysis. Perit Dial Int J Int Soc Perit Dial. janv 1984;4(1):35‑7.
5. Kim S, Yu YM, Kwon J, Yoo H, Jung SH, Lee E. Calcium Channel Blocker-Associated Chyloperitoneum in Patients Receiving Peritoneal Dialysis: A Systematic Review. Int J Environ Res Public Health. 2019;16(8):1333.
6. Campisi C, Bellini C, Eretta C, Zilli A, da Rin E, Davini D, et al. Diagnosis and management of primary chylous ascites. J Vasc Surg. 2006;43(6):1244‑8.
7. Almakdisi T, Massoud S, Makdisi G. Lymphomas and chylous ascites: review of the literature. The Oncologist. 2005;10(8):632‑5.
8. Kato A, Kohno S, Ohtake T, Takita T, Hirshida A. Chylous ascites in an adult patient with nephrotic syndrome due to membranous nephropathy. Nephron. 2001;89(3):361.
9. Falcon TG, Rodriguez-Carmona A, Fontán MP, Rivera CF, Bouza P, Lozano IR, et al. Complications of permanent catheter implantation for peritoneal dialysis: incidence and risk factors. Adv Perit Dial. 1994;10:206‑206.
10. Jhittay PS, Wolverson RL, Wilson AO. Acute chylous peritonitis with associated intestinal tuberculosis. J Pediatr Surg. janv 1986;21(1):75‑6.
11. Yoshimoto K, Saima S, Nakamura Y, Nakayama M, Kubo H, Kawaguchi Y, et al. Dihydropyridine type calcium channel blocker-induced turbid dialysate in patients undergoing peritoneal dialysis. Clin Nephrol. 1998;50(2):90‑3.
12. Gaied H, Joseph M. Péritonite chyleuse secondaire à Lercanidipine. Bull Dial À Domic. 2018;1(1):43‑6.
13. Eroglu E, Cirak A, Kocyigit I. Lercanidipine Induced Cloudy Effluent in a Patient with Peritoneal Dialysis. Jour Ren Med. 2017;1(2):10.
14. Ram R, Swarnalatha G, Pai BS, Rao CSS, Dakshinamurty KV. Cloudy peritoneal fluid attributable to non-dihydropyridine calcium channel blocker. Perit Dial Int. 2012;32(1):110‑1.
15. Yoshimoto K, Saima S, Echizen H, Nakamura Y, Ishizaki T. A drug-induced turbid peritoneal dialysate in five patients treated with continuous ambulatory peritoneal dialysis. Clin Nephrol. 1993;40(2):114‑7.
16. Cárdenas A, Chopra S. Chylous ascites. Am J Gastroenterol. 2002;97(8):1896.
17. McKeage K, Scott LJ. Manidipine. Drugs. 2004;64(17):1923‑40.
18. Betancourt-Castellanos L, Ponz-Clemente E, Otero-López MS, Blasco-Cabañas C, Marquina-Parra D, García-García M. Turbid acellular peritoneal fluid and the use of calcium antagonists in peritoneal dialysis. Nefrología. 2013;33(3):377‑80.
19. Hsiao PJ, Lin HW, Sung CC, Wang CW, Chu P, Lin SH. Incidence and clinical course of lercanidipine-associated cloudy effluent in continuous ambulatory peritoneal dialysis. Clin Nephrol. 2010;74(3):217‑22.
20. Topal C, Sayarlioglu H, Dogan E, Erkoc R, Soyoral Y. Cloudy dialysate due to lercanidipine. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc. oct 2006;21(10):2997‑8.
21. Rampino T, Dal Canton A. Peritoneal dialysis and epithelial-to-mesenchymal transition. N Engl J Med. 15 mai 2003;348(20):2037‑9; author reply 2037-2039.
22. Yang W-S, Huang J-W, Chen H-W, Tsai T-J, Wu K-D. Lercanidipine-induced chyloperitoneum in patients on peritoneal dialysis. Perit Dial Int. 1 nov 2008;28(6):632‑6.
23. Apikotoa S, Wijesuriya R. Idiopathic acute chylous peritonitis during pregnancy, mimicking perforated acute appendicitis: A case report. Int J Surg Case Rep. 2021;81:105790.
24. Bhardwaj R, Vaziri H, Gautam A, Ballesteros E, Karimeddini D, Wu GY. Chylous ascites: a review of pathogenesis, diagnosis and treatment. J Clin Transl Hepatol. 2018;6(1):105.
25. Lopez-Gutierrez JC, Tovar JA. Chylothorax and chylous ascites: management and pitfalls. In: Seminars in pediatric surgery. Elsevier; 2014. p. 298‑302.
26. Browse NL, Wilson NM, Russo F, Al-Hassan H, Allen DR. Aetiology and treatment of chylous ascites. J Br Surg. 1992;79(11):1145‑50.

Published

2021-09-08

How to Cite

1.
Abid H, Toumi S, Chaker H, Fandri B, Agrebi I, Dammak N, Mseddi F, Kammoun K, Yaich S, Ben Hmida M. Chylous peritonitis in peritoneal dialysis. Bull Dial Domic [Internet]. 2021 Sep. 8 [cited 2022 Nov. 26];4(3):175-81. Available from: https://www.bdd.rdplf.org/index.php/bdd/article/view/62623