Abstract：
Chyloperitoneum (chylous ascites) is a rare complication of peritoneal dialysis (PD). Its causes may be traumatic and nontraumatic, associated with neoplastic disease, autoimmune disease, retroperitoneal fibrosis, or rarely calcium antagonist use. We describe six cases of chyloperitoneum occurring in patients on PD as a sequel to calcium channel blocker use. The dialysis modality was automated PD (two patients) and continuous ambulatory PD (the rest of the patients). The duration of PD ranged from a few days to 8 years. All patients had a cloudy peritoneal dialysate, characterized by a negative leukocyte count and sterile culture tests for common germs and fungi. Except for in one case, the cloudy peritoneal dialysate appeared shortly after the initiation of calcium channel blockers (manidipine, n = 2; lercanidipine, n = 4), and cleared up within 24-72 h after withdrawal of the drug. In one case in which treatment with manidipine was resumed, peritoneal dialysate clouding reappeared. Though turbidity of PD effluent is due in most cases to infectious peritonitis, there are other differential causes including chyloperitoneum. Although uncommon, chyloperitoneum in these patients may be secondary to the use of calcium channel blockers. Being aware of this association can lead to prompt resolution by suspension of the potentially offending drug, avoiding stressful situations for the patient such as hospitalization and invasive diagnostic procedures.
摘要：
乳糜腹膜（乳糜腹水）是腹膜透析（PD）的罕见并发症。它的原因可能是创伤性和非创伤性的，与肿瘤疾病相关，自身免疫性疾病，腹膜后纤维化,或很少使用钙拮抗剂。我们描述了PD患者中发生的6例乳糜腹膜，这是钙通道阻滞剂使用的后遗症。透析方式是自动PD（两名患者）和连续卧床PD（其余患者）。PD的持续时间从几天到8年不等。所有患者都有混浊的腹膜透析液，以白细胞计数阴性和常见细菌和真菌的无菌培养试验为特征。除了一种情况,钙通道阻滞剂开始后不久出现浑浊的腹膜透析液(马尼地平，n=2；乐卡地平，n=4),并在停药后24-72小时内清除。在一个病例中，恢复了用马尼地平治疗，腹膜透析液再次出现混浊。尽管在大多数情况下，PD流出物的浊度是由于传染性腹膜炎，还有其他不同的原因，包括乳糜腹膜。虽然不常见，这些患者的乳糜腹膜可能继发于钙通道阻滞剂的使用。意识到这种关联可以通过暂停潜在的犯罪药物来迅速解决，避免患者的紧张情况，如住院和侵入性诊断程序。
