Incidence of Pleural Effusion and its causes in Chronic Kidney Disease Patients

Abstract

Background: Chronic renal failure problems are seen more frequently in uremic patients as a result of the increasing prevalence of long-term hemodialysis and longer life spans. Such patients may experience a variety of thoracic and extra-thoracic issues, with uremic pleuritis, pleural effusion, and pericarditis being the most common. Objective: To assess the incidence of pleural effusions and its etiology in hemodialysis patients with chronic renal failure. Methodology:  This was a cross-sectional study, conducted at theDepartment of Nephrology, Lady Reading Hospital, Peshawar from Jan 2022 to July 2022. In this study, patients undergoing hemodialysis for chronic kidney disease were enrolled. Confirmation of CKD was done by renal function tests and imaging, revealing chronic renal parenchymal changes. Pleural effusion was confirmed on clinical and radiological findings. diagnostic aspiration was done especially for unilateral and suspected pathological pleural effusion and was sent for pleural fluid examination. For exudative lymphocytic pleural effusion, the pleural biopsy was done by Abrahams's needle while neutrophilic exudative fluid was sent for C/S, and chest intubation was performed by pulmonology colleagues. Results: A total of 500 hemodialysis patients took part in the research. The patients' ages varied between 20 to 60. The patients' mean age was 39.80 + 5.245 years. The ratio of men to women was 2.6:1. Pleural effusion was noted in 127 sufferers (25.4%). Conclusion: Patients getting long-term hemodialysis often experience pleural effusion. Pleural effusion is common in patients receiving long-term hemodialysis. It could be bilateral or unilateral. Bilateral is mostly transudative while unilateral effusion is mostly exudative. Unilateral pleural effusion is not uncommon in CKD patients because of immunocompromised status and must not be overlooked.  Key Words: Chronic Kidney Disease (CKD); Hemodialysis; Pleural Effusion; End stage renal disease (ESKD)