RT Journal Article
SR Electronic
T1 Pleural effusion in chronic kidney disease: An ongoing dilemma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P583
VO 40
IS Suppl 56
A1 Somenath Kundu
A1 Subhra Mitra
A1 Souvik Ray
A1 Subhasis Mukherjee
A1 Ritabrata Mitra
A1 Joydeep Ganguly
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P583.abstract
AB Background: Pleural effusion among patients of chronic kidney diseases (CKD) is an ongoing dilemma to nephrologists and pulmonologists especially in developing countries where tuberculosis is a common cause of pleural effusion. While uremic effusion is a diagnosis of exclusion, the sensitivity and specificity of various modalities of diagnosis of tuberculous effusion vary.Methods: A prospective cross-sectional observational study of all adult patients of pleural effusion with either CKD (stages 3 to 5) or renal transplant attending a tertiary-care institute in eastern India was performed over a year. An analysis of the etiological profile, clinical characteristics and treatment modalities of pleural effusion in CKD was carried out.Results: 430 CKD (stages 3 to 5) patients and 34 post renal transplant patients were evaluated during the study period. Incidence of pleural effusion was 6.74% (29/430) in CKD patients and 5.88% (2/34) in post transplant patients. Exudative effusion was slightly more predominant (51.6%, 16 of 31) but heart failure remained the single most common etiology (41.9%, 13 of 31).Tuberculosis (n=8, 25.8%) and uremic effusion (n=6, 19.4%) were responsible for the majority of exudative effusions,followed by empyema (n=2).Conclusion: Symptomatic pleural effusion was present in 6.74% patients of CKD (stages 3 to5) and in 5.88% of post transplant patients. Heart failure, tuberculosis and uremic effusion accounted for 41.9%, 25.5% and 19.4% cases respectively. Differentiating tuberculosis from uremic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary in view of its strong therapeutic implications.