{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:46:56Z","timestamp":1791913616336,"version":"4.3.4"},"reference-count":26,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u00b1 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\u201372 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.<\/jats:p>","DOI":"10.3390\/jcm8040466","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T11:36:01Z","timestamp":1554464161000},"page":"466","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Calcium Channel Blocker-Related Chylous Ascites: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-0501","authenticated-orcid":false,"given":"Meng-Ko","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan"},{"name":"National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hung","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Mien","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7786-5497","authenticated-orcid":false,"given":"Gwo-Ping","family":"Jong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung 40201, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"ref_1","first-page":"260","article-title":"Chylous ascites: Diagnosis, causes and treatment","volume":"63","author":"Laterre","year":"2002","journal-title":"Acta Gastroenterol. Belg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1111\/jcpt.12555","article-title":"Lercanidipine-induced chylous ascites: Case report and literature review","volume":"42","author":"Basualdo","year":"2017","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_3","first-page":"C50","article-title":"Amlodipine induced chylous ascites in a patient undergoing peritoneal dialysis","volume":"3","author":"Gupta","year":"2016","journal-title":"Ann. Appl. Bio-Sci."},{"key":"ref_4","first-page":"114","article-title":"A drug-induced turbid peritoneal dialysate in five patients treated with continuous ambulatory peritoneal dialysis","volume":"40","author":"Yoshimoto","year":"1993","journal-title":"Clin. Nephrol."},{"key":"ref_5","first-page":"90","article-title":"Dihydropyridine type calcium channel blocker-induced turbid dialysate in patients undergoing peritoneal dialysis","volume":"50","author":"Yoshimoto","year":"1998","journal-title":"Clin. Nephrol."},{"key":"ref_6","first-page":"195","article-title":"Manidipine hydrochloride-induced chyloperitoneum in a patient with systemic lupus erythematosus","volume":"51","author":"Tanabe","year":"1999","journal-title":"Clin. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.1093\/ndt\/gfl269","article-title":"Cloudy dialysate due to lercanidipine","volume":"21","author":"Topal","year":"2006","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1177\/089686080802800615","article-title":"Lercanidipine-induced chyloperitoneum in patients on peritoneal dialysis","volume":"28","author":"Yang","year":"2008","journal-title":"Perit. Dial. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1038\/ki.2008.334","article-title":"Calcium channel blocker-induced chylous ascites in peritoneal dialysis","volume":"75","author":"Tsao","year":"2009","journal-title":"Kidney Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"217","DOI":"10.5414\/CNP74217","article-title":"Incidence and clinical course of lercanidipine-associated cloudy effluent in continuous ambulatory peritoneal dialysis","volume":"74","author":"Hsiao","year":"2010","journal-title":"Clin. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1038\/ki.2009.372","article-title":"Regarding \u2018Calcium channel blocker induced chylous ascites in peritoneal dialysis\u2019","volume":"7","author":"Graice","year":"2010","journal-title":"Kidney Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110","DOI":"10.3747\/pdi.2010.00277","article-title":"Cloudy peritoneal fluid attributable to non-dihydropyridine calcium channel blocker","volume":"32","author":"Ram","year":"2012","journal-title":"Perit. Dial. Int."},{"key":"ref_13","first-page":"683","article-title":"Non-infectious cloudy peritoneal fluid secondary to lercanidipine","volume":"34","year":"2014","journal-title":"Nefrologia"},{"key":"ref_14","first-page":"1","article-title":"Lercanidipine-induced cloudy effluent in a patient with peritoneal dialysis","volume":"1","author":"Eroglu","year":"2017","journal-title":"J. Renal Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jps.2600620102","article-title":"Lipophilic character and biological activity of drugs. II. The parabolic case","volume":"62","author":"Hansch","year":"1973","journal-title":"J. Pharm. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1021\/ci500276x","article-title":"Target-independent prediction of drug synergies using only drug lipophilicity","volume":"54","author":"Yilancioglu","year":"2014","journal-title":"J. Chem. Inf. Model."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S1574-1400(08)00012-1","article-title":"Chapter 12\u2014PubChem: Integrated Platform of Small Molecules and Biological Activities","volume":"4","author":"Bolton","year":"2008","journal-title":"Ann. Rep. Comput. Chem."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1002\/bjs.1800791110","article-title":"Aetiology and treatment of chylous ascites","volume":"79","author":"Browse","year":"1992","journal-title":"Br. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1016\/S0002-9270(02)04268-5","article-title":"Chylous ascites","volume":"97","author":"Cardenas","year":"2002","journal-title":"Am. J. Gastroenterol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Al-Busafi, S.A., Ghali, P., Deschenes, M., and Wong, P. (2014). Chylous ascites: Evaluation and management. ISRN Hepatol., 2014.","DOI":"10.1155\/2014\/240473"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jamcollsurg.2011.01.010","article-title":"Atraumatic chylous ascites: Systematic review on symptoms and causes","volume":"212","author":"Steinemann","year":"2011","journal-title":"J. Am. Coll. Surg."},{"key":"ref_22","first-page":"366","article-title":"Diseases of the lymphatics","volume":"96","author":"Browse","year":"2003","journal-title":"J. R. Soc. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5409","DOI":"10.1113\/jphysiol.2014.280347","article-title":"Distinct roles of L-and T-type voltage -dependent Ca2 channels in regulation of lymphatic vessel contractile activity","volume":"592","author":"Lee","year":"2014","journal-title":"J. Physiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"358","DOI":"10.7326\/0003-4819-96-3-358","article-title":"Evaluation and management of chylous ascites","volume":"96","author":"Press","year":"1982","journal-title":"Ann. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.jvs.2005.11.064","article-title":"Diagnosis and management of primary chylous ascites","volume":"43","author":"Campisi","year":"2006","journal-title":"J. Vasc. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1067\/msy.2000.109502","article-title":"Chylous ascites: A collective review","volume":"128","author":"Aalami","year":"2000","journal-title":"Surgery"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/4\/466\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:43:18Z","timestamp":1760186598000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/4\/466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,5]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4]]}},"alternative-id":["jcm8040466"],"URL":"https:\/\/doi.org\/10.3390\/jcm8040466","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,5]]}}}