Chylothorax and chylopericardium in a dialysis patient

A 24-year-old man with acute kidney injury underwent intermittent hemodialysis using a right intrajugular venous catheter for 4 months. Subsequently, he was determined to have kidney failure for which a left arm arteriovenous fistula (AVF) was created. After creating the AVF, he developed dyspnea and left arm swelling. Computed tomography chest showed bilateral pleural and pericardial effusions (Supplementary Figure S1). A right chest tube and pericardial drain extracted milky fluid (Supplementary Figures S2 and S3) with triglyceride levels of 1008 mg/dL and 1349 mg/dL, respectively, leading to the diagnoses of chylothorax and chylopericardium.