A cross-sectional prospective study of pleural effusion among cases of chronic kidney disease.
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Date
2013-10
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Abstract
Background. Pleural effusions of diverse aetiologies are encountered in patients with chronic kidney disease (CKD). The
objectives of the present study were to examine the frequency of occurrence, causes, clinical features and management
strategies of pleural effusion in patients with CKD including renal transplant recipients.
Methods. A prospective cross-sectional observational analysis of pleural effusion in adult patients with CKD (stages 3 to 5)
attending the Departments of Nephrology and Respiratory Medicine of a tertiary care institution in Eastern India was
performed over a period of one year (February 2010 to January 2011).
Results. Pleural effusion was found in 29 out of 430 patients with CKD (6.7%) and in two out of 34 post-renal transplant
recipients (5.9%) evaluated during the study period. The mean age was 37.35±1.8 (mean±SEM [standard error of mean])
with a male to female ratio of 2:1. Exudates and transudates were found in equal frequencies. Heart failure was the single
most common cause (41.9%, 13 of 31). Tuberculosis (TB) (n=8, 25.8%) and uraemic effusions (n=6, 19.4%) were responsible
for the majority of exudates. Unilateral effusion with a normal heart size had a positive predictive value of 83.3% for nonheart
failure aetiology.
Conclusions. Symptomatic pleural effusion was present in a small proportion of 6.7%; (n=29) patients with CKD including
post-renal transplant recipients. Heart failure, TB and uraemic effusions accounted for most of the cases. Differentiating
TB from uraemic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary
for proper management.
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Keywords
Pleural effusion, Chronic kidney disease, Heart failure, Tuberculosis, Uraemic pleuritis
Citation
Ray Souvik, Mukherjee Subhasis, Ganguly Joydeep, Abhishek Kumar, Mitra Subhra, Kundu Somenath. A cross-sectional prospective study of pleural effusion among cases of chronic kidney disease. The Indian Journal of Chest Diseases and Allied Sciences, 2013 Oct; 55(4): 209-213.