Faruk EKİNCİ, Rıza Dinçer YILDIZDAŞ, Özden Özgür HOROZ, Engin MELEK, Ercüment PETMEZCİ, İlknur TOLUNAY

Konjenital nefrotik sendromlu bir infantta periton diyalizine bağlı olarak görülen nadir bir komplikasyon olarak şiloz asit

Şilöz asit; periton diyalizi yapılan hastalarda nadir görülen fakat önemli bir non-enfeksiyöz komplikasyondur. Konjenial nefrotik sendromlu 1,5 aylık erkek hasta genel durumunda kötüleşme, diffüz ödematöz görünüm ve solunum sıkıntısı nedeni ile çocuk yoğun bakım ünitesine kabul edildi. Yatışının üçüncü gününde periton diyaliz kateteri takılarak periton diyalizi uygulanmaya başlandı. Periton diyaliz kateteri takıldıktan beş gün sonra (yatışının sekizinci gününde) diyaliz sıvısı süt görünümü almaya başladı. Süt görünümündeki sıvının biyokimyasal analizi şilöz asit karakteri gösteriyordu: trigliserit 468 mg/dl. Şilöz asit kısa zincirli yağ asitlerinden zengin düşük lipidli diyet ve somatostatin analogu (octreotid) infüzyonu ile tedavinin 5. gününde düzeldi ve hasta tedavinin devamı için pediatri servisine transfer edildi.

Chylous ascites: an unusual complication of peritoneal dialysis in an infant with congenital nephrotic syndrome

Chylous ascites is a rare but important non-infectious complication in patients undergoing peritoneal dialysis. A male infant of 1.5-month-old with congenital nephrotic syndrome admitted to our pediatric intensive care unit becasue of deterioration in general appearence, diffuse edematous appearance and respiratory distress. Peritoneal catheter insertion and peritoneal dialysis was performed in the 3rd day of hospitalization. Five days after peritoneal dialysis catheter insertion (on the 8th day of hospitalization) the peritoneal dialysis effluent had a milky appearance. The chemical analysis of the milky effluent showed characteristics of chylous ascites: triglycerides 468 mg/dl. The chylous ascites resolved at the 5th day of our treatment with a low fat diet with medium chain triglycerides and intravenous infusion of somatostatin analogue (octreotide) and the patient was transferred to the pediatric service for maintenance of the treatment.

Keywords:

Chylous ascites, non-infectious complications, peritoneal dialysis,

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