Uremic pleuritis in chronic hemodialysis patients

Rashid-Farokhi, Farin; Pourdowlat, Guitti; Nikoonia, Mohammad-Reza; Behzadnia, Neda; Kahkouee, Shahram; Nassiri, Amirahmad; Masjedi, Mohammadreza

doi:10.1111/j.1542-4758.2012.00722.x

Cited by 22 publications

(25 citation statements)

References 13 publications

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“…The fluid overload between HD sessions and abnormal permeability of the pulmonary microcirculation have been cited as causes of acute pulmonary edema (noncardiogenic) and pleural effusion (28) that can reduce volumes and lung capacity over time. This respiratory complication changes the ventilation/perfusion relationship (with or without the presence of anemia), reduces gas exchange, tissue oxygenation, and, consequently, functional capacity (activities of daily living) and exercise tolerance (29)(30)(31) .…”

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Soares¹,

Oliveira‐Silva²,

Silva³

et al. 2020

mtprehabjournal

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Background: Patients undergone hemodialysis (HD) suffer with energy-protein malnutrition, uremic myopathy and protein catabolism reducing their functional capacity, tolerance to exercise and aspects related to quality of life. Objective: The aim of this study was to evaluate the effects of the two protocols of inspiratory muscle training (IMT) on muscle strength, pulmonary function and related-health quality of life on male HD patients. Methods: Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), peak expiratory flow (PEF), forced expiratory volume in first second (FEV 1 ), forced vital capacity (FVC) and the FEV 1 /FVC ratio and quality of life were evaluated pre and post six months of IMT in HD patients. IMT was performed by one group using a specific training (Power breathe) device (T-IMT, n=19) and by the other with incentive spirometry (I-IMT, n= 15). Results: Following the inspiratory training, muscle strength improved in both groups. The group that used incentive spirometry had increments in MIP larger (39.8%, p<0.001) than the group that trained with the specific training device (28.3%, p=0.001). The KDQOL-SF dimensions showed significant difference in the T-IMT group in cognitive function (p=0.03), sexual function (p=0.009) and social function dimensions (p=0.04) and in the I-IMT group in the physical function dimension (p=0.03). Conclusion: It was proved that IMT improved muscle strength and I-IMT promoted increments significantly larger in MIP. Aspects of health-related quality of life of HD male patients improved significantly with T-IMT (sexual, social and cognitive functions), while I-IMT ameliorated only physical function.

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Section: Discussionmentioning

confidence: 99%

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Soares¹,

Oliveira‐Silva²,

Silva³

et al. 2020

mtprehabjournal

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“…Uremic pleuritis is a unique etiology for HD patients. Although it is classically thought of as pleural effusion in patients with ESRD without HD, it has recently been reported that uremic pleuritis exists even in patients already receiving HD and is underestimated [2]. A recent study reported that uremic pleuritis comprised 40% of exudative effusion and was the most common etiology of exudative effusion [1].…”

Section: Discussionmentioning

confidence: 99%

“…Common etiologies of pleural effusion in this patient group are heart failure, volume overload, parapneumonic effusion, tuberculotic pleuritis, and uremic pleuritis [2]. Because of the frequency with which this complication is associated with volume overload or heart failure, empirical reduction of the dry weight (DW) is often attempted without thoracentesis [1].…”

Section: Introductionmentioning

confidence: 99%

Primary Effusion Lymphoma in an Elderly HIV-Negative Patient with Hemodialysis: Importance of Evaluation for Pleural Effusion in Patients Receiving Hemodialysis

Sasaki¹,

Isegawa²,

Shimabukuro³

et al. 2014

Case Rep Nephrol Dial

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Pleural effusion is a ubiquitous complication in hemodialysis (HD) patients. Common etiologies of pleural effusion in this patient group are heart failure, volume overload, parapneumonic effusion, tuberculotic pleuritis, and uremic pleuritis. Although thoracentesis is a useful diagnostic method of pleural effusion, empirical reduction of the dry weight is often attempted without thoracentesis because pleural effusion is commonly caused by volume overload and responds to the dry-weight reduction. However, this empiricism has a risk of overlooking or delaying the diagnosis of potentially fatal etiologies that need specific treatments. We report an 86-year-old human immunodeficiency virus (HIV)-negative male on HD with primary effusion lymphoma (PEL), a large-cell non-Hodgkin lymphoma presenting with characteristic lymphomatous effusions in the absence of solid tumor masses, which is in association with human herpes virus 8 (HHV8) infection in immunocompromised individuals. The patient presented with left-sided pleural effusion. This is the first case report of PEL developing in a patient receiving HD. Thoracentesis and cytological analysis of the effusion was key to the diagnosis. We also review the literature regarding pleural effusion in HD patients. Further, we examine Kaposi's sarcoma herpes virus/HHV8-negative effusion-based lymphoma, a newly proposed distinct lymphoma that clinically and cytomorphologically resembles PEL, because it can be cured without chemotherapy. This report may arouse clinicians' attention regarding the importance of evaluation for pleural effusion in HD patients, especially when the effusion or symptoms associated with pleural effusion are refractory to volume control.

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“…[2][3][4][5][6] Pleural effusions from pneumonia or uremic pleuritis typically are exudative by both criteria. [7][8][9][10][11][12][13][14][15] In addition, transudative effusions as a result of CHF or CO are paucicellular with low neutrophil counts. Pleural effusions resulting from pneumonia or uremic pleuritis have a higher TNC and ANC and higher protein and LDH concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Cell counts, especially neutrophil counts, are higher in uremic pleural effusions than in CHF. [7][8][9] To our knowledge, the effect of ESRD on the PFA as a result of CO in the absence of clinical signs of uremic pleuritis has not been reported to date. We found a statistically signifi cant difference in protein concentrations and pleural fl uid/serum protein ratios in pleural effusions in ESRDCOCHF compared with SCHF.…”

Section: Esrd With Co or Chfmentioning

confidence: 95%

Effects of Coexisting Pneumonia and End-stage Renal Disease on Pleural Fluid Analysis in Patients With Hydrostatic Pleural Effusion

Doelken

Huggins

Goldblatt

et al. 2013

Chest

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Background: In individual patients, especially those who are hospitalized, several conditions often coexist that may be responsible for the development of a pleural effusion and may affect the pleural fl uid analysis (PFA). The objective of this study was to investigate the effects of end-stage renal disease and pneumonia on PFA in patients with hydrostatic pleural effusion. Methods:In a retrospective analysis of 1,064 consecutive patients who underwent thoracentesis at a university hospital, cell counts and pleural fl uid protein, lactate dehydrogenase, pH, and glucose levels were examined in those (n 5 300) with clinical evidence of hydrostatic pleural effusion. Results: The 300 patients (28.1%) with pleural effusions had congestive heart failure (CHF), circulatory overload (CO), or both. Expert consensus was achieved in 66 (22%) for CHF as the sole diagnosis (SCHF), 30 (10%) for CHF and coexisting pneumonia (PCHF), and 26 (8.7%) for end-stage renal disease (ESRD) with coexisting CO or CHF. The remaining 178 patients were excluded because of complicating conditions. There were minor, but statistically signifi cant differences in pleural fl uid/serum protein ratios in patients with ESRD with coexisting CO or CHF compared with SCHF. Compared with SCHF, there were statistically signifi cant tendencies for higher protein and lactate dehydrogenase concentrations and lower pH levels in those with PCHF. The total nucleated cell count and the absolute neutrophil count were signifi cantly higher in PCHF. Conclusions: ESRD in patients with hydrostatic pleural effusions has a minimal effect on the PFA. Coexisting pneumonia most often results in an exudative effusion in patients with CHF.CHEST 2013; 143(6):1709-1716Abbreviations: ANC 5 absolute neutrophil count; CHF 5 congestive heart failure; CO 5 circulatory overload; ESRD 5 endstage renal disease; ESRDCOCHF 5 end-stage renal disease with coexisting circulatory overload or congestive heart failure; LDH 5 lactate dehydrogenase; PCHF 5 congestive heart failure and coexisting pneumonia; PFA 5 pleural fl uid analysis; SCHF 5 congestive heart failure as the sole diagnosis; TNC 5 total nucleated cell count

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Uremic pleuritis in chronic hemodialysis patients

Cited by 22 publications

References 13 publications

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Primary Effusion Lymphoma in an Elderly HIV-Negative Patient with Hemodialysis: Importance of Evaluation for Pleural Effusion in Patients Receiving Hemodialysis

Effects of Coexisting Pneumonia and End-stage Renal Disease on Pleural Fluid Analysis in Patients With Hydrostatic Pleural Effusion

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