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慢性肾脏病患者的漏出性与渗出性胸腔积液:一项前瞻性单中心研究

Transudative and Exudative Pleural Effusion in Chronic Kidney Disease Patients: A Prospective Single-Center Study.

作者信息

Jabbar Asfia, Qureshi Ruqaya, Nasir Kiran, Dhrolia Murtaza, Ahmad Aasim

机构信息

Nephrology, The Kidney Centre Post Graduate Training Institute, Karachi, PAK.

出版信息

Cureus. 2021 Oct 10;13(10):e18649. doi: 10.7759/cureus.18649. eCollection 2021 Oct.

Abstract

Objective The aim of the study is to assess the incidence of pleural effusion and to assess its etiology in admitted chronic kidney disease patients who were admitted secondary to various causes, i.e., fluid overload, sepsis, etc. Material and methods A prospective cross-sectional observational study was conducted at the Department of Nephrology, The Kidney Centre Postgraduate Training Institute, Karachi. A total of 789 patients were admitted between August 2020-February 2021. This study comprised 280 adult chronic kidney disease (chronic kidney disease and end-stage renal disease patients who were on dialysis) patients having pleural effusion (either unilateral or bilateral) secondary to various causes.  Results Among 280 patients, the mean age was 55 years with 158 (56.4%) males and 122 (43.6%) females, diabetes (76%) was present in most of the patients along with hypertension (86.1%), and most of the patients were of stage IV and V. Transudative pleural effusion was present in 212 (75.7%) patients secondary to fluid overload and heart failure was the commonest cause while 68 (24.3%) patients had exudative pleural effusion with tuberculosis being the commonest etiology, 44 (15.7%) patients needed intervention while 236 (84.3%) were treated medically. The data was entered and analyzed on SPSS version 21 (IBM Corp, Armonk, USA). The cleaning and coding of data were done before analysis. Continuous variables were expressed in mean ± standard deviation, while the frequencies with percentages were obtained for categorical variables. The Chi-square test was applied to see the association between variables. A p-value of ≤ 0.05 was considered significant. Conclusion Clarification of the cause of pleural effusion is essential. Early diagnosis and prompt treatment like thoracocentesis or in the case of patients on hemodialysis, adequate dialysis may be necessary.

摘要

目的 本研究旨在评估因各种原因(如液体超负荷、败血症等)入院的慢性肾脏病患者胸腔积液的发生率及其病因。材料与方法 在卡拉奇肾脏中心研究生培训学院肾脏病科进行了一项前瞻性横断面观察研究。2020年8月至2021年2月期间共收治了789例患者。本研究纳入了280例因各种原因继发胸腔积液(单侧或双侧)的成年慢性肾脏病(慢性肾脏病及接受透析的终末期肾病患者)患者。结果 在280例患者中,平均年龄为55岁,男性158例(56.4%),女性122例(43.6%),大多数患者患有糖尿病(76%)以及高血压(86.1%),且大多数患者处于IV期和V期。212例(75.7%)患者因液体超负荷出现漏出性胸腔积液,最常见的原因是心力衰竭;而68例(24.3%)患者出现渗出性胸腔积液,最常见的病因是结核病,44例(15.7%)患者需要干预,236例(84.3%)患者接受药物治疗。数据录入并使用SPSS 21版(美国纽约州阿蒙克市IBM公司)进行分析。在分析前对数据进行清理和编码。连续变量以均值±标准差表示,分类变量以频率和百分比表示。应用卡方检验观察变量之间的关联。p值≤0.05被认为具有统计学意义。结论 明确胸腔积液的病因至关重要。早期诊断并及时治疗,如胸腔穿刺术,或者对于接受血液透析的患者,可能需要进行充分的透析。

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