Uremic pleural effusion. A study in 14 patients on chronic dialysis.

During a 21/2-year period, studies were done on 14 patients with chronic renal failure to evaluate pleural effusions which we believe were secondary to the uremic process. The patients with uremic pleural effusions closely resembled those in the group with chronic renal failure as a whole with respect to diagnosis and clinical features. Fever and pericarditis were noted in half the patients. The pleural fluid appeared serosanguineous or hemorrhagic in 10 of 14 patients and contained a predominance of lymphocytes more often than of neutrophils. Elevated protein and lactic dehydrogenase (LDH) levels gave the effusion characteristics of an exudate. Pleural tissue obtained by pleural biopsy or autopsy showed chronic fibrinous pleuritis in every patient. With continued dialysis the effusions resolved in 4 to 6 weeks after thoracentesis in 11 patients and recurred in 3 patients.