Filarial chyluria: Long-term experience of a University Hospital in India

Abstract

Chyluria is relatively common in tropical and subtropical countries. Various regimens have been proposed for treatment of chyluria. These include a variety of drugs, irrigation of the renal pelvis with silver nitrate, and interruption and stripping of the renal pedicle. Chyluria often occurs in conjunction with other conditions, and can often be managed effectively by the treatment of these coexisting conditions. Treatment of coexisting conditions should be the initial therapeutic approach.1 Renal pelvic instillation with silver nitrate is effective for chyluria, although the recurrence rate is high.2 The authors have shown that chyluria ceased in 68 of 76 patients with surgical treatment and recurred in eight patients (10%, on the same side in four and on the opposite side in four). In our previous study, lymphography revealed bilateral lymphaticorenal fistulae in 54% of chylurial patients.3 Chylurial recurrence on the contralateral side also needs to be considered. Additionally, surgical interruption and stripping of renal pedicle lymphatics runs the risk of nephrectomy and renal dysfunction occurring, although the rate of complications is low. Surgical treatment should be performed only as a last resort.