Etiology and Profile of Pleural Effusion Among Chronic Kidney Disease Patients Attending a Tertiary Care Centre: An Observational Study
Main Article Content
Keywords
Chronic kidney disease, pleural effusion, exudative effusion
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.
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Dr Hashim Mohammed
Pulmonary Medicine Senior Resident, KMCT Medical College, Mukkam Kerala University of Health Sciences ORCID ID : 0009-0009-8707-1496
Dr Athul Thulasi
Pulmonology Assistant Professor , Travancore Medical College, Kerala University of Health Sciences [email protected] ORCID ID :0000-0002-6301-7470
Balachandran J
Pulmonary Medicine Professor and Head, Travancore Medical College, Kollam Kerala University of Health Sciences [email protected] ORCID ID : 0009-0006-2375-2370
Dr Sreedas Gopalakrishnan
Nephrology, Associate Professor of General Medicine ,Travancore Medical College, Kollam, Kerala University of Health Sciences
