부산대학교 도서관

BACKGROUND: Chyloperitoneum (CHYLO) and eosinophilic peritonitis (EP) are uncommon complications in peritoneal dialysis (PD) patients. However, peritoneal function and clinical outcome after the episode of CHYLO or EP have rarely been studied. METHODS: We conducted a single-center retrospective study enrolled patients diagnosed with CHYLO and EP, who were followed-up regularly in our PD out-patient department from January 1, 2006 to December 31, 2021 in Tri-Service General Hospital. The clinical profile of etiology of end stage kidney disease, comorbidities, presentation at the time of onset, laboratory reports, and peritoneal function were retrieved. Follow-up peritoneal function, clearance, and nutritional status were also analyzed and compared. RESULTS: In these 14 individuals, 7 patients were diagnosed CHYLO and the other seven patients with EP. The mean age of the CHYLO group was 62 ± 0 years and 47 ± 0.7 years in the EP group. More than half of 14 patients were diagnosed with chronic glomerulonephritis prior to initiating PD. The most common comorbidities were hypertensive cardiovascular diseases. Four CHYLO patients were caused by animal fat and nuts intake. The other three CHYLO patients noticed milky white dialysate fluid after using lercanidipine. All CHYLO patients achieved complete remission after adjusting their diet and discontinuing offending drugs. Five EP patients experienced mild turbid dialysate effluent after initiating PD. This was caused by hypersensitive reactions to PD materials. This allergic process was normally self-limited, except one patient who required oral steroids. One patient developed EP after using vancomycin to control bacterial peritonitis. Another EP patient had an idiopathic cause. These 2 EP patients also required oral steroids to achieve remission. The mean values of inflammatory parameters at the time of event were as follows: neutrophil-to-lymphocyte, 3.87% in CHYLO and 5.90% in EP; C-reactive protein, 0.40 mg/dL in CHYLO and 3.78 mg/dL in EP; and serum albumin, 3.36 g/dL in CHYLO and 3.59 g/dL in EP. Follow-up 6 months of standard peritoneal equilibrium test, Kt/V, weekly creatinine clearance, and normalized protein nitrogen appearance showed no significant changes in both CHYLO or EP patients. CONCLUSION: CHYLO and EP are rare forms of peritonitis, and these types of non-infectious peritonitis are considered benign without obvious adverse effects on dialysis adequacy. Early identified risk factors can assist clinicians to provide accurate diagnosis and treatment.