Unexplained exudative pleural effusion in chronic peritoneal dialysis patients.
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.
Kwan
Bonnie Ching-Ha
BC
Department of Medicine & Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
Chow
Kai-Ming
KM
Pang
Wing-Fai
WF
Leung
Chi-Bon
CB
Li
Philip Kam-Tao
PK
Szeto
Cheuk-Chun
CC
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
D015314:Dialysis Solutions