Abstract
ObjectiveThe aim of the study is to assess the incidence of pleural effusion and to assess its etiology in admitted chronic kidney disease patients who were admitted secondary to various causes, i.e., fluid overload, sepsis, etc.Material and methodsA prospective cross-sectional observational study was conducted at the Department of Nephrology, The Kidney Centre Postgraduate Training Institute, Karachi. A total of 789 patients were admitted between August 2020-February 2021. This study comprised 280 adult chronic kidney disease (chronic kidney disease and end-stage renal disease patients who were on dialysis) patients having pleural effusion (either unilateral or bilateral) secondary to various causes. ResultsAmong 280 patients, the mean age was 55 years with 158 (56.4%) males and 122 (43.6%) females, diabetes (76%) was present in most of the patients along with hypertension (86.1%), and most of the patients were of stage IV and V. Transudative pleural effusion was present in 212 (75.7%) patients secondary to fluid overload and heart failure was the commonest cause while 68 (24.3%) patients had exudative pleural effusion with tuberculosis being the commonest etiology, 44 (15.7%) patients needed intervention while 236 (84.3%) were treated medically. The data was entered and analyzed on SPSS version 21 (IBM Corp, Armonk, USA). The cleaning and coding of data were done before analysis. Continuous variables were expressed in mean ± standard deviation, while the frequencies with percentages were obtained for categorical variables. The Chi-square test was applied to see the association between variables. A p-value of ≤ 0.05 was considered significant.ConclusionClarification of the cause of pleural effusion is essential. Early diagnosis and prompt treatment like thoracocentesis or in the case of patients on hemodialysis, adequate dialysis may be necessary.
Highlights
Chronic kidney disease (CKD) is recognized as a major health problem
Continuous variables were expressed in mean ± standard deviation, while the frequencies with percentages were obtained for categorical variables
Pleural effusion (PE) and pulmonary edema are common clinical presentations in CKD patients [3], which occur mostly due to fluid overload and increased capillary permeability of visceral and parietal pleura
Summary
Chronic kidney disease (CKD) is recognized as a major health problem. The load of CKD is swiftly increasing, its estimated prevalence is about 13.4%, while in Pakistan more than 17 million people are suffering from kidney diseases [1]. The current international consensus definition of CKD [2] states that CKD is defined as abnormalities of kidney structure or function, present for > three months, with implications for health. Patients with CKD develop various systemic complications and respiratory complications are of utmost importance and clinically significant. Pleural effusion (PE) and pulmonary edema are common clinical presentations in CKD patients [3], which occur mostly due to fluid overload and increased capillary permeability of visceral and parietal pleura. In patients with renal involvement, it is a common diagnostic dilemma as it may arise because of CKD itself. PE can be unilateral or bilateral and can vary from mild to massive
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