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Unexplained exudative pleural effusion in chronic peritoneal dialysis patients
Bonnie Ching-Ha Kwan1, Kai-Ming Chow, Wing-Fai Pang
1Department of Medicine & Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Summary
Uremic pleuritis in chronic peritoneal dialysis (PD) patients can present as unexplained exudative or transudative pleural effusion. Unexplained exudative effusion indicates high mortality, suggesting intensified dialysis may improve survival.
Area of Science:
- Nephrology
- Pulmonology
- Internal Medicine
Background:
- Uremic pleuritis is a known condition in chronic kidney disease patients.
- The clinical significance and outcomes of pleural effusion in peritoneal dialysis (PD) patients are not well-defined.
Purpose of the Study:
- To investigate the diagnostic patterns and clinical outcomes of pleural effusion in chronic PD patients.
- To assess the prognostic implications of different types of pleural effusion in this population.
Main Methods:
- Retrospective study of 82 chronic PD patients with pleural effusion.
- Review of diagnosis patterns and clinical outcomes, including survival and technique survival.
Main Results:
- 22 patients had unexplained exudative effusion, associated with significantly lower 3-year survival (40.9%) and technique survival (74.2%) compared to unexplained transudative effusion.
- Intensified PD regimens in patients with unexplained exudative effusion correlated with improved 3-year survival (100%) versus those with unchanged regimens (52.6%).
Conclusions:
- Unexplained exudative pleural effusion is a significant finding in chronic PD patients, carrying a high mortality risk.
- Intensified dialysis regimens should be considered for PD patients presenting with unexplained exudative pleural effusion to improve outcomes.
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