title: Unexplained exudative pleural effusion in chronic peritoneal dialysis patients.
abstract: BACKGROUND
  Although the clinico-pathological entity of uremic pleuritis has long been recognized, its clinical significance remains poorly defined. ♢
  
  
  METHODS
  We retrospectively studied 82 chronic peritoneal dialysis (PD) patients that had pleural effusion. The pattern of diagnosis and clinical outcome were reviewed. ♢
  
  
  RESULTS
  10 patients had overt fluid overload and thoracocentesis was not performed, 23 had other specific diagnoses, 15 had transudative effusion due to fluid overload, 12 had unexplained transudative effusion, and 22 patients had unexplained exudative effusion. The 3-year actuarial survival was 40.9% and 83.3% for patients with unexplained exudative and transudative effusion respectively (p = 0.012); technique survival was 74.2% and 90.9% respectively (p = 0.006). For patients with unexplained exudative effusion, 11 patients had their PD regimen intensified: they had a higher 3-year actuarial survival than those with their dialysis regimen unchanged (100.0% vs 52.6%, p = 0.04). ♢
  
  
  CONCLUSIONS
  Unexplained exudative pleural effusion is not uncommon in chronic PD patients. These patients have a high mortality; an intensive dialysis regimen may be considered.
authors.affiliation: Department of Medicine & Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors.forename: Bonnie Ching-Ha
authors.initials: BC
authors.lastname: Kwan
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Wing-Fai
authors.initials: WF
authors.lastname: Pang
authors.forename: Chi-Bon
authors.initials: CB
authors.lastname: Leung
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
authors.forename: Cheuk-Chun
authors.initials: CC
authors.lastname: Szeto
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002423:Cause of Death; D016009:Chi-Square Distribution; D002908:Chronic Disease; D015331:Cohort Studies; D015314:Dialysis Solutions / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D010996:Pleural Effusion / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D013997:Time Factors
chemical_list: D015314:Dialysis Solutions