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Year: 2025
Type: paratext
Abstract: Introduction Chronic kidney disease (CKD) represents a major public health burden and is commonly associated with systemic complications, including cardiovascular disease, infections, and fluid accumulation in serous cavities. Pleural effusion is a frequent finding in CKD patients and may arise from multiple etiologies such as fluid overload related to renal or cardiac dysfunction, uremic pleuritis, infections, or malignancy. Identifying the underlying cause of pleural effusion is essential for appropriate clinical management. This study was conducted to evaluate the etiological profile and characteristics of pleural effusion among CKD patients attending a tertiary care centre in Kerala. Objectives To evaluate the etiologies of pleural effusion in patients with CKD and determine the proportion of transudative and exudative effusions. The study also aimed to analyze pleural fluid biochemical, pathological, and microbiological characteristics, as well as assess the nature and size of pleural effusions in the study population. Methods This cross-sectional study included CKD patients diagnosed with pleural effusion at a tertiary healthcare facility in Kerala, irrespective of dialysis status. A comprehensive evaluation was performed, including clinical history, physical examination, and relevant investigations. Pleural fluid analysis comprised biochemical, cytological, and microbiological assessment. Effusions were classified as transudative or exudative based on Light’s criteria. The distribution of etiologies and demographic characteristics of the study population were analysed. Results Transudative pleural effusions were the most common, observed in 60.6% of patients, predominantly due to fluid overload associated with CKD (33.8%) and congestive heart failure (28.2%). Exudative effusions accounted for 39.4% of cases, with parapneumonic effusions being the most frequent (16.9%), followed by tuberculosis (14.1%). Exudative effusions were more commonly unilateral. Pleural fluid analysis was instrumental in differentiating infectious and malignant effusions from transudative causes. Conclusion Transudative pleural effusions due to volume overload related to CKD and congestive heart failure constitute the majority of pleural effusions in CKD patients. Among exudative effusions, parapneumonic effusion is the most common etiology, followed by tuberculosis. Early identification of the underlying cause of pleural effusion is essential for optimizing management and improving outcomes in CKD patients. Further studies are needed to refine diagnostic and therapeutic strategies in this population.
DOI: 10.53555/13tn2770
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W7130503552
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