Abstract
We report a 36-year-old male patient on continuous ambulatory peritoneal dialysis (CAPD) who underwent cadaveric renal transplantation on May 18, 1994. He had been administrated manidipine hydrochloride (a dihydropyridine type of calcium channel blocker) for hypertension since May 19, 1994. After about 96 hours, he noticed remarkable turbidity of his drained dialysate, and he experienced low grade fever, slight abdominal pain and left hypogastric tenderness. We suspected infectious peritonitis.
This dialysate showed no leukocyte count, no growth in bacterial and fungal cultures, and an elevated triglyceride concentration [27.2mg/dl (a clear dialysate: 0.5mg/dl)], so we diagnosed chyloperitoneum. His drained dialysate became tubid just after the administration of manidipine hydrochloride, and became clear within 24 hours after withdrawal of the drug. Therefore, we suspected that manidipine hydrochloride-induced chyloperitoneum.
We suggest that if immunocompromised hosts such as renal transplant patients have chyloperitoneum during CAPD, the administration of manidipine hydrochloride should be stopped. Because signs of chyloperitoneum were nonspecific in these patients, we could not distinguish chyloperitoneum from complicated infectious peritonitis clinically.
