Prevalence of Respiratory Manifestations in Chronic Kidney Diseases; A Descriptive Cross-sectional Study in A Tertiary Care Hospital of Nepal

Pant, Pankaj; Baniya, Santosh; Jha, Ashish

doi:10.31729/jnma.4284

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…The prevalence of pleural effusion as the most common respiratory complication found in our study (9.2%) followed by pneumonia and pulmonary edema was different from the study that reports pulmonary edema as the most common pulmonary complication [7]. Pathogenesis of pleural effusion and pulmonary edema has been explained to be multifactorial, which includes increased hydrostatic pressure due to volume overload and decreased plasma oncotic pressure owing to albumin loss through urine [8][9][10].…”

Section: Discussioncontrasting

confidence: 63%

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A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis

Shaik¹,

Thotamgari²,

Kowtha³

et al. 2021

Cureus

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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. MethodologyA 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. ResultsOur 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. ConclusionOur 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 nonreporting 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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Section: Discussioncontrasting

confidence: 63%

“…Respiratory illnesses comprise a majority of debilitating complications of ESRD [7]. Many etiologies have been discussed in recent literature, which cause ESRD, including diabetes mellitus, hypertension, glomerulopathies, infection, renal stones, vesicoureteric reflux, and congenital conditions like polycystic kidney disease [4].…”

Section: Discussionmentioning

confidence: 99%

A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis

Shaik¹,

Thotamgari²,

Kowtha³

et al. 2021

Cureus

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“…11 The prevalence of pneumonia in our study was significantly higher than another similar national study. 3 One possible reason behind this could be the inclusion of Covid-19 pneumonia in our study that was prevalent during the duration of our study. The mean age of the study was 60.43±17.55 years which was quite similar to a study conducted in Taiwan with a mean age of 64±16.0.…”

Section: Discussionmentioning

confidence: 99%

Pneumonia in Patients with Chronic Kidney Disease Admitted to Nephrology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

et al. 2021

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Introduction: Chronic Kidney Disease is an independent risk factor for pneumonia. The risk of hospitalization, Intensive Care Unit and ventilator requirement, in-hospital death is high in pneumonia patients with chronic kidney disease. This study aims to find the prevalence of pneumonia in patients with chronic kidney disease admitted to nephrology department of a tertiary care center. Methods: A descriptive cross-sectional study was conducted among all the hospital records of pneumonia patients with Chronic Kidney Disease admitted to the Nephrology department between April 2019 and April 2021. Ethical clearance was obtained from the Institutional Review Committee of same institute (Reference number: 0505202106). Statistical Package for the Social Sciences version 20 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 407 patients with Chronic Kidney Disease, 78 (19.1%) (95% Confidence Interval= 15.28-22.92) had pneumonia. Among the 78 pneumonia patients, 17 (21.8%) were Stage 3, 13 (16.7%) Stage 4 and 48 (61.5%) Stage 5 of chronic kidney disease. Forty Seven (60.3%) required Intensive Care Unit (ICU), 19 (24.4%) required ventilator and 22 (28.2%) of the patient expired in hospital. The most commonly isolated organisms were Severe Acute Respiratory Syndrome Coronavirus 2 which was 13 (16.6%) followed by Strepotococcus pneumoniae which was 8 (10.2%). Conclusions: The prevalence of pneumonia in Chronic Kidney Disease was observed higher in our study compared to other studies.

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“…Portanto, esses achados comuns de pacientes com DRET em TRS podem ser fatores de confusão ao interpretar os achados da TC para o diagnóstico da COVID-19. Além disso, esses pacientes também parecem apresentar diversas alterações pulmonares crônicas e agudas prévias que também podem colocar em dúvida a interpretação da TC de tórax [10][11][12] . Outra questão importante é que o tratamento das alterações pulmonares na COVID-19 é completamente diferente da congestão pulmonar relacionada à sobrecarga de volume, muito comum em pacientes com DRET.…”

Section: Discussionunclassified

“…Relatórios preliminares mostraram um aumento no risco de óbito para essa população [7][8][9] . Além disso, a apresentação clínica de pacientes com DRET com doenças respiratórias no pronto-socorro (PS) também é desafiadora, uma vez que eles podem apresentar diversas condições pulmonares subjacentes [10][11][12] . Tais doenças podem ter achados clínicos, laboratoriais e radiológicos semelhantes que geralmente ajudam no diagnóstico da COVID-19 13 .…”

Section: Introductionunclassified

Padrões de tomografia computadorizada da COVID-19 em pacientes em terapia renal substitutiva

Carmo,

Oliveira,

Campos

et al. 2024

Braz. J. Nephrol.

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RESUMO Introdução: Doenças pulmonares são comuns em pacientes com doença renal em estágio terminal (DRET), dificultando o diagnóstico diferencial com COVID-19. Este estudo descreve achados de tomografia computadorizada de tórax (TC) em pacientes com DRET em terapia renal substitutiva (TRS) hospitalizados com suspeita de COVID-19. Métodos: Indivíduos maiores de 18 anos com DRET, encaminhados ao pronto-socorro com suspeita de COVID-19 foram incluídos. Dados clínicos e epidemiológicos foram extraídos de registros eletrônicos de saúde. A TC foi classificada como típica, indeterminada, atípica, negativa. Comparamos achados tomográficos de pacientes com COVID-19 positivos e negativos. Resultados: Recrutamos 109 pacientes (62,3% COVID-19-positivos) entre março e dezembro de 2020, idade média de 60 ± 12,5 anos, 43% mulheres. A etiologia mais comum da DRET foi diabetes. Tempo médio em diálise foi 36 meses, intervalo interquartil = 12–84. A lesão pulmonar mais comum foi opacidades em vidro fosco. O padrão típico de TC foi mais comum em pacientes com COVID-19 (40 (61%) vs. 0 (0%) em pacientes sem COVID-19, p < 0,001). Sensibilidade 60,61% (40/66), especificidade 100% (40/40). Valores preditivos positivos e negativos foram 100% e 62,3%, respectivamente. Padrão atípico de TC foi mais frequente em pacientes COVID-19-negativos (9 (14%) vs. 24 (56%) em COVID-19-positivos, p < 0,001), enquanto padrão indeterminado foi semelhante em ambos os grupos (13 (20%) vs. 6 (14%), p = 0,606), e padrão negativo foi mais comum em pacientes COVID-19-negativos (4 (6%) vs. 12 (28%), p = 0,002). Conclusões: Em pacientes com DRET em TRS hospitalizados, um padrão atípico de TC de tórax não pode excluir adequadamente o diagnóstico de COVID-19.

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Prevalence of Respiratory Manifestations in Chronic Kidney Diseases; A Descriptive Cross-sectional Study in A Tertiary Care Hospital of Nepal

Cited by 4 publications

References 9 publications

A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis

A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis

Pneumonia in Patients with Chronic Kidney Disease Admitted to Nephrology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

Padrões de tomografia computadorizada da COVID-19 em pacientes em terapia renal substitutiva

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