title: A cross-sectional prospective study of pleural effusion among cases of chronic kidney disease.
abstract: BACKGROUND
  Pleural effusions of diverse aetiologies are encountered in patients with chronic kidney disease (CKD). The objectives of the present study were to examine the frequency of occurrence, causes, clinical features and management strategies of pleural effusion in patients with CKD including renal transplant recipients.
  
  
  METHODS
  A prospective cross-sectional observational analysis of pleural effusion in adult patients with CKD (stages 3 to 5) attending the Departments of Nephrology and Respiratory Medicine of a tertiary care institution in Eastern India was performed over a period of one year (February 2010 to January 2011).
  
  
  RESULTS
  Pleural effusion was found in 29 out of 430 patients with CKD (6.7%) and in two out of 34 post-renal transplant recipients (5.9%) evaluated during the study period. The mean age was 37.35 +/- 1.8 (mean +/- SEM [standard error of mean]) with a male to female ratio of 2:1. Exudates and transudates were found in equal frequencies. Heart failure was the single most common cause (41.9%, 13 of 31). Tuberculosis (TB) (n = 8, 25.8%) and uraemic effusions (n = 6, 19.4%) were responsible for the majority of exudates. Unilateral effusion with a normal heart size had a positive predictive value of 83.3% for non-heart failure aetiology.
  
  
  CONCLUSIONS
  Symptomatic pleural effusion was present in a small proportion of 6.7%; (n = 29) patients with CKD including post-renal transplant recipients. Heart failure, TB and uraemic effusions accounted for most of the cases. Differentiating TB from uraemic effusion requires a combined clinico-pathological approach and this differentiation is absolutely necessary for proper management.
authors.forename: Souvik
authors.initials: S
authors.lastname: Ray
authors.forename: Subhasis
authors.initials: S
authors.lastname: Mukherjee
authors.forename: Joydeep
authors.initials: J
authors.lastname: Ganguly
authors.forename: Kumar
authors.initials: K
authors.lastname: Abhishek
authors.forename: Subhra
authors.initials: S
authors.lastname: Mitras
authors.forename: Somenath
authors.initials: S
authors.lastname: Kundu
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D019468:Disease Management; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D062072:Patient Acuity; D010996:Pleural Effusion / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D012307:Risk Factors