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J. Clin. Med. 2019, 8(4), 466;

Calcium Channel Blocker-Related Chylous Ascites: A Systematic Review and Meta-Analysis

Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan
National Defense Medical Center, Taipei 11490, Taiwan
Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung 40201, Taiwan
Authors to whom correspondence should be addressed.
Received: 10 February 2019 / Revised: 27 March 2019 / Accepted: 3 April 2019 / Published: 5 April 2019
(This article belongs to the Section Molecular Medicine)
PDF [226 KB, uploaded 5 April 2019]


Background: Chylous ascites is an uncommon condition characterized by a white, milky-appearing peritoneal fluid, and is related to disruption of the lymphatic system from any cause. There have been very few previous reports of calcium channel blockers (CCBs) as potential causes of chylous ascites, and most of the patients were undergoing peritoneal dialysis. Aims: To review the pathogenesis, clinical manifestations, laboratory examinations, treatment options, and prognosis of patients with CCB-related chylous ascites. Method: A retrospective analysis was conducted for patients with CCB-related chylous ascites from publications in PubMed, EMBASE, and LILACS between January 1993 and December 2018. Results: A total of 48 cases were included. The average age at disease onset was 50.2 ± 10.9 years, with a male:female ratio of 1.5:1.0. The symptoms of abdominal distension/pain and chylous ascites were observed within 48–72 h of drug initiation and disappeared within 24 h of drug withdrawal. Rechallenge was performed in 10 patients, and all (100%) of them showed chylous effluents that disappeared within 24 h after stopping drug treatment. Conclusions: To summarize, CCB-related chylous ascites is formed of white, milky ascites/effluents that appear after administration of CCBs. Physicians must be aware of the possibility of chylous ascites when administering CCBs, particularly in patients with renal function impairment or patients with end-stage renal disease who are undergoing peritoneal dialysis.
Keywords: chylous ascites; calcium channel blockers; milky ascites/effluents; end-stage renal disease chylous ascites; calcium channel blockers; milky ascites/effluents; end-stage renal disease
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Tsai, M.-K.; Lai, C.-H.; Chen, L.-M.; Jong, G.-P. Calcium Channel Blocker-Related Chylous Ascites: A Systematic Review and Meta-Analysis. J. Clin. Med. 2019, 8, 466.

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