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Sato Y, Takahashi Y, Tasaki K. Trapped lung and refractory pleural effusion in a patient receiving peritoneal dialysis. Ther Apher Dial 2023; 27:976-977. [PMID: 37082860 DOI: 10.1111/1744-9987.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Yuya Sato
- Department of Nephrology and Rheumatology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Yusuke Takahashi
- Department of Nephrology and Rheumatology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Kazuyuki Tasaki
- Department of Nephrology and Rheumatology, Saiseikai Niigata Hospital, Niigata, Japan
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Shaik L, Thotamgari SR, Kowtha P, Ranjha S, Shah RN, Kaur P, Subramani R, Katta RR, Kalaiger AM, Singh R. A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis. Cureus 2021; 13:e15426. [PMID: 34249571 PMCID: PMC8254517 DOI: 10.7759/cureus.15426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the trends of end-stage renal disease (ESRD) in patients undergoing maintenance hemodialysis (MHD) and find the correlation with effects on the pulmonary system in such patients. Methodology A multicentric prospective study was conducted in the city of Solapur, India. Data were collected from 250 patients through interpersonal interrogation using a questionnaire to capture basic demographic details, the history of ESRD, and relevant respiratory symptoms like breathlessness, cough, fever, etc. related to their disease. Symptoms that are likely associated with the pulmonary system were analyzed and referred to the pulmonology department. Appropriate diagnoses were made using relevant diagnostic tools like X-rays and sputum studies. The association between various disease attributes and pulmonary diagnoses was analyzed using the chi-square (χ2) test, with a p-value of value less than or equal to 0.05 considered statistically significant. Various socio-demographic variables, existing comorbidities, occupation-related risk factors, smoking history, past or current history of any respiratory conditions, the association between the causes of ESRD, time since the first dialysis and sociodemographic factors, and frequency of pulmonary complications were the other covariates in the study. Results Our study reports that 31.6% of our patients had significant impairment in their functioning due to respiratory complaints. The prevalence of respiratory complications was 27.2%. Major contributors were pleural effusion (33.8), pneumonia (25), pulmonary edema (20.58), pleuritis (11.76), collapse (8.8), tuberculosis (5.8), fibrosis (4.4), pericardial effusion (4.4), calcification (2.9), and hydrothorax (1.47). We report one case of Urinothorax as a rare cause of hydrothorax in such patients. Overall, our analysis found a significant association between non-reporting of respiratory complaints and acute admissions to the intensive care unit (ICU) with a respiratory cause at p-value 0.0076 with a greater predilection toward the rural populations. Conclusion Our study results highlight the prevalence of pulmonary complications in ESRD patients. The occurrence of pulmonary complications, irrespective of the presence of symptoms and a greater association between non-reporting of respiratory symptoms and acute admissions to the ICU, is a hallmark to consider the importance of history and clinical vigilance during patient visits.
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Affiliation(s)
| | - Sahith Reddy Thotamgari
- Research (Cardiovascular Diseases), Mayo Clinic, Rochester, USA.,Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | | | | | - Rutul N Shah
- Internal Medicine, M. P. Shah Government Medical College, Jamnagar, IND
| | - Parneet Kaur
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Internal Medicine, Department of Health and Family Welfare, Government of Punjab, Chandigarh, IND.,Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, IND
| | - Rashmi Subramani
- Internal Medicine: Pulmonology, Saveetha Medical College and Hospital, Chennai, IND.,Contact Tracer Specialist, Larkin Community Hospital, Florida, USA
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Rashid-Farokhi F, Pourdowlat G, Nikoonia MR, Behzadnia N, Kahkouee S, Nassiri AA, Masjedi MR. Uremic pleuritis in chronic hemodialysis patients. Hemodial Int 2012; 17:94-100. [DOI: 10.1111/j.1542-4758.2012.00722.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Guitti Pourdowlat
- Chronic Respiratory Disease Research Center, NRITLD; Masih Daneshvari Hospital; Shahid Beheshti University of Medical Sciences; Tehran; Iran
| | - Mohammad-Reza Nikoonia
- Chronic Respiratory Disease Research Center, NRITLD; Masih Daneshvari Hospital; Shahid Beheshti University of Medical Sciences; Tehran; Iran
| | | | | | - Amir-Ahmad Nassiri
- Department of Nephrology and Hemodialysis; Masih Daneshvari Hospital; Shahid Beheshti University of Medical Sciences; Tehran; Iran
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Hamming I, Berend K, Ajubi N, Engels R, Develter W. An unusual cause of pleural effusion in a haemodialysis patient. Clin Kidney J 2009; 2:164-6. [PMID: 25949318 PMCID: PMC4421364 DOI: 10.1093/ndtplus/sfn208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 12/18/2008] [Indexed: 11/15/2022] Open
Affiliation(s)
- Inge Hamming
- Kidney Center, University Medical Center Groningen and University Hospital Groningen, Groningen, The Netherlands
| | - Kenrick Berend
- Hemodialysis Department, St Elisabeth Hospital, Willemstad, Curaçao Netherlands Antilles
| | - Nouaf Ajubi
- Hemodialysis Department, St Elisabeth Hospital, Willemstad, Curaçao Netherlands Antilles
| | - Rauf Engels
- Hemodialysis Department, St Elisabeth Hospital, Willemstad, Curaçao Netherlands Antilles
| | - Willem Develter
- Hemodialysis Department, St Elisabeth Hospital, Willemstad, Curaçao Netherlands Antilles
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Abstract
The pleura and lung are intimately associated and share many pathologic conditions. Nevertheless, they represent two separate organs of different embryonic derivation and with different yet often symbiotic functions. In this article, the authors explore the pathologic manifestations of the many conditions that primarily or secondarily affect the pleura.
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Affiliation(s)
- John C English
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC, Canada
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Abstract
INTRODUCTION Pleural effusions are common in ICU patients. Causes include massive fluid resuscitation in shock, pneumonia--either community acquired or nosocomial, cardiac insufficiency, hypoalbuminemia and hepatic impairment. Pleural effusions frequently complicate cardiac and abdominal surgery and haemothorax may complicate trauma. STATE OF THE ART The incidence of pleural effusions in the intensive care unit (ICU) varies depending on the screening method used, from about 8% for physical examination to more than 60% for routine ultrasonography. In the absence of clinical parameters to exclude infection pleurocentesis remains an essential aspect of management and is not contraindicated mechanical ventilation. This review of the diagnosis and management of pleural effusions in ICU patients reports the most recent data from the literature. Pleurocentesis can be performed safely in the ICU, even in mechanically ventilated patients. The absence of reliable clinical or laboratory test criteria for determining the cause of pleural effusions and the potentially devastating consequences of failing to diagnose and treat pleural infection are strong reasons to perform pleurocentesis in patients with clinically detectable pleural effusions and no contraindication to the procedure. PERSPECTIVES Although the data reviewed indicate that the diagnosis and treatment of pleural effusions should follow the same rules in the ICU as they do elsewhere, several incompletely resolved issues deserve further investigation. These are summarised in an agenda for future research.
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Affiliation(s)
- E Azoulay
- Service de Reanimation Médicale, hôpital Saint-Louis et Université Paris VII, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Abstract
The incidence of pleural effusions in the intensive care unit varies depending on the screening methods, from approximately 8% for physical examination to more than 60% for routine ultrasonography. Several factors contribute to the occurrence of pleural effusions in intensive care unit patients: large amounts of intravenous fluid are often administered, pneumonia is common, and heart failure, atelectasis, extravascular catheter migration, hypoalbuminemia, or liver disease are present in many intensive care unit patients. In surgical intensive care units, cardiac or abdominal surgery is often followed by pleural effusions, and in trauma patients, hemothorax is a dreaded event. Because no clinical parameter excludes pleural infection, and because of the impact of thoracentesis on diagnosis and treatment, this procedure should be performed unless contraindicated. Thoracentesis is safe in mechanically ventilated patients. The author discusses the following points regarding pleural effusions in the intensive care unit: screening intensive care unit patients for pleural effusion, safety of thoracentesis in patients receiving invasive mechanical ventilation, distinguishing exudates from transudates, and diagnosing and managing infected pleural effusions in critically ill patients. Lastly, the author suggests a research agenda for pleural effusions in intensive care unit patients.
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Affiliation(s)
- Elie Azoulay
- Service de Réanimation Médicale, Hôpital Saint-Louis et Université Paris, France.
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