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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2020  |  Volume : 31  |  Issue : 3  |  Page : 687-692
Chylous nephrogenic ascites in a hemodialysis patient

1 Department of Renal Medicine, RIPAS Hospital, Bandar Seri Begawan BA1710, Brunei Darussalam
2 Faculty of Medicine, University of New South Wales, Sydney, Australia

Correspondence Address:
Muhammad Abdul Mabood Khalil
Department of Renal Medicine, RIPAS Hospital, Bandar Seri Begawan BA1710
Brunei Darussalam
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-2442.289455

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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.

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