Chylous nephrogenic ascites in a hemodialysis patient

Chylous nephrogenic ascites is rare in hemodialysis (HD) patients. We would like to share a rare case of chylous nephrogenic ascites in a HD patient. The patient has a history of straw-colored nephrogenic ascites which was drained through pigtail five times in the past. Later on, the ascites became...

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Bibliographic Details
Published in:Saudi journal of kidney diseases and transplantation 2020-05, Vol.31 (3), p.687-692
Main Authors: Chong, Vui Heng, Jukmin, Muhammad Khayr al-Sadiq Hajj, Khalil, Muhammad Abd al-Mabud, Tan, Jackson
Format: Article
Language:English
Subjects:
Abdomen
Ascites
Catheters
Fistula
Fluids
Heart failure
Hemodialysis
Hypertension
Kidney diseases
Liver
Liver cirrhosis
Noncompliance
Patients
Peritoneal dialysis
Pulmonary arteries
Sepsis
Tuberculosis
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Summary:Chylous nephrogenic ascites is rare in hemodialysis (HD) patients. We would like to share a rare case of chylous nephrogenic ascites in a HD patient. The patient has a history of straw-colored nephrogenic ascites which was drained through pigtail five times in the past. Later on, the ascites became turbid and milky. The chloroform test of the ascitic fluid showed fat globules with Oil Red-O stain, and the triglyceride concentration of ascitic fluid was 168.14 mg/dL (1.93 mmol/L) satisfying the criteria of chylous ascites. We believe that this may be caused by microtrauma from repeated pigtail insertions for ascites which was compounded by inadequate HD and noncompliance with fluids. Routine investigations including screening for malignancy, tuberculosis, cirrhosis, and heart failure did not reveal any other possible causes. Although there are few case reports of chylous ascites in peritoneal dialysis patients, it has never been reported in patients on HD.
ISSN:1319-2442
2320-3838
DOI:10.4103/1319-2442.289455