Urinothorax: a systematic review.
María E Toubes1, Adriana Lama1, Lucía Ferreiro1,2
1Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Journal of Thoracic Disease
|June 16, 2017
Summary
Urinothorax (UT) is typically caused by trauma, presenting as unilateral pleural effusion. Treatment targeting the uropathy, not just fluid evacuation, leads to better outcomes.
Area of Science:
- Nephrology
- Pulmonology
- Urology
Background:
- Urinothorax (UT) patient characteristics are not well-defined.
- Understanding UT is crucial for effective patient management.
Purpose of the Study:
- To systematically review and define the characteristics of patients with urinothorax.
- To identify the most effective treatment strategies for UT.
Main Methods:
- Systematic review of 78 studies including case descriptions and retrospective data.
- Analysis of clinical findings, pleural fluid characteristics, and treatment outcomes in 88 UT patients.
Main Results:
- Urinothorax is predominantly traumatic (76%), unilateral (87%), with straw-colored or hematic pleural fluid (PF) and a urine-like odor.
- Pleural fluid/serum creatinine ratio >1 in 97.9% of cases; diagnosis often relies on this ratio or contrast extravasation.
- Successful treatment (96.1%) involved addressing the uropathy, with unfavorable outcomes when only thoracentesis/drainage was used.
Conclusions:
- Urinothorax is commonly traumatic and unilateral, lacking specific pleural fluid patterns.
- A pleural fluid/serum creatinine ratio greater than 1 is a key diagnostic indicator.
- Effective treatment necessitates addressing the underlying uropathy, potentially alongside pleural fluid evacuation.
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