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Association between peritoneal dialysate effluent leukocytosis and amlodipine besylate

Fan Lee1, Mei-Ching Yu

  • 1Division of Nephrology, Yee Zen General Hospital and Asia Renal Care-Taiwan Branch, Yang Mei Town, Taoyuan, Taiwan, ROC.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|January 27, 2009
PubMed

Insights

Dialysate effluent leukocytosis, often indicating infection, can be caused by amlodipine in peritoneal dialysis patients. Discontinuation of this medication normalized lymphocyte levels in a pediatric case.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Clinical Pharmacology

Background:

  • Peritoneal dialysis (PD) patients with dialysate effluent leukocytosis typically suggest infection or inflammation.
  • Understanding non-infectious causes of effluent leukocytosis is crucial for accurate diagnosis and management.

Observation:

  • A pediatric patient with end-stage renal disease (ESRD) secondary to crescent glomerulonephritis and interstitial nephritis presented with unexplained dialysate effluent leukocytosis.
  • The leukocytosis was characterized by a predominance of lymphocytes in the dialysate effluent.

Findings:

  • Discontinuation of amlodipine besylate therapy led to the normalization of the effluent cell count within one week.
  • A subsequent amlodipine rechallenge confirmed it as the causative agent for the observed effluent leukocytosis.

Implications:

  • Amlodipine can be an unrecognized cause of dialysate effluent leukocytosis in pediatric PD patients.
  • This finding highlights the importance of considering medication side effects in the differential diagnosis of effluent abnormalities in PD.
  • Further investigation into amlodipine's mechanism in causing PD-related leukocytosis may be warranted.

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