Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria?

Abstract

or 'recurrence' of chyluria were treated with second course of RPIS using same sclerosant. RESULTSThe dextrose treatment was discontinued at mid-term because of poor success (one of 21 patients, P < 0.001). Of 85 patients, 44 received silver nitrate and 41 povidone iodine; both groups were well-matched and the mean follow-up was 28.4 and 23.3 months, respectively. 'Immediate clearance' was recorded in 91% and 98%, and recurrence in 21% and 22% of patients after the first course of RPIS, after silver nitrate and povidone, respectively; Kaplan-Meier estimates of 'disease-free duration' in the two groups (23.6 vs 20.1 months) were also similar ( P = 0.7906). The cumulative success rate after two courses of RPIS was 82% (silver nitrate) and 83% (povidone; P = 1.0). Five (11%) patients in the silver nitrate and one (2%) in the povidone group had significant flank pain during treatment. CONCLUSIONSPovidone iodine 0.2% is as effective for RPIS as 1% silver nitrate.

Comparison of Two Approaches to Retroperitoneoscopic Renal Pedicle Lymphatic Disconnection for Chyluria

“…Conservative treatments, including bed rest, more water, and a fat-restricted, high-protein diet are recommended for those with mild chyluria or in poor condition without tolerance for surgery. Instillation of the renal pelvis with silver nitrate or povidone iodine has been used, [6][7][8] and because of the drawbacks of recurrence and repeated instillation and pain, this procedure is now less adopted.…”

An occult filarial infection presenting as chyluria with proteinuria: a case report and review of literature

“…Povidone-iodine 0.2% is also considered to be as effective as 1% silver nitrate therapy. The cumulative success rate after two courses of therapy was 82% (silver nitrate) and 83% (povidone) 15. Surgical or retroperitoneoscopic pyelolymphatic disconnection is the treatment of choice for those who fail the renal pelvic instillation sclerotherapy.…”

Factors affecting response to medical management in patients of filarial chyluria: A prospective study

“…The severity of chyluria was graded according to the prevalent clinical grading system,[91011] incorporating slight modifications as per the severity of hematuria as mentioned below:…”