Hemorrhagic Pleural Effusion in Patients Undergoing Chronic Hemodialysis

Galen, M. A.

doi:10.7326/0003-4819-82-3-359

Cited by 54 publications

(28 citation statements)

References 11 publications

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“…Parietal pleural tissue obtained by open or closed biopsy has shown chronic fibrinous inflammation, mesothelial cell hyperplasia and fibrinous change with chronic inflammation and serosanguineous or hemorrhagic pleural effusion has been found in patients receiving long-term hemodialysis [7, 11]. Thus, serosanguineous or hemorrhagic pleural fluid with elevated protein, glucose, and LDH levels indicate uremic pleural effusion in patients with chronic renal failure [11].…”

Section: Discussionmentioning

confidence: 99%

“…Traumatic thoracentesis is a risk, particularly since hemothorax can induce a fibrinous reaction. Because of this danger, heparin should be avoided altogether or applied minimally when dialysis is required [7]. The value of local or systemic corticosteroids or nonsteroidal anti-inflammatory agents has not been established.…”

Section: Discussionmentioning

confidence: 99%

“…When a fibrous pleural peel develops and restricts respiration, surgical decortication is required [7]. Persistent atelectasis eventually reduces surfactants.…”

Section: Discussionmentioning

confidence: 99%

“…Galen et al [7]have described patients with significant hemorrhagic pleural effusions that seemed to be attributable to an uremic state. Experience with treating uremic pleurisy and pleural effusion indicates that effusions may take several weeks to resolve.…”

Section: Introductionmentioning

confidence: 99%

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Prognosis of Patients with Rounded Atelectasis Undergoing Long-Term Hemodialysis

Horita¹,

Noguchi

Miyazaki³

et al. 2001

Nephron

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We present 4 patients undergoing hemodialysis in whom thoracic computed tomography (CT) suggested a diagnosis of rounded atelectasis (RA) with pleural effusion. The clinical setting and follow-up CT of all 4 patients confirmed this diagnosis. The pleural fluid of each appeared serosanguineous or hemorrhagic and predominantly consisted of lymphocytes. Biochemical analysis of this fluid revealed high levels of total protein, lactate dehydrogenase and glucose. Bacterial culture and polymerase chain reaction for Mycobacterium tuberculosis DNA was negative. Pleural biopsy specimens from 2 of the 4 patients showed evidence of fibrinous change and mesothelial cell hyperplasia. Pleural effusion from all 4 patients did not respond to either fluid restriction or aggressive hemodialysis-induced dehydration. The subsequent clinical course and thoracentesis were repeated, and in 1 patient, this was followed by tetracycline pleurodesis. However, 2 patients died during pre-pleurodesis and 1 died during post-pleurodesis, all due to respiratory failure. We propose that the clinical setting and follow-up thoracic CT and thoracentesis of patients receiving long-term hemodialysis confirmed a diagnosis of rounded atelectasis with uremic pleural effusion. We also propose that the prognosis of patients with refractory pleural effusion receiving long-term hemodialysis would be improved by early pleurodesis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…When a fibrous pleural peel develops and restricts respiration, surgical decortication is required [7]. Persistent atelectasis eventually reduces surfactants.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognosis of Patients with Rounded Atelectasis Undergoing Long-Term Hemodialysis

Horita¹,

Noguchi

Miyazaki³

et al. 2001

Nephron

View full text Add to dashboard Cite

show abstract

“…Chronic hemodialysis is associated with spontaneous hemorrhage occurring mostly in the gastrointestinal tract [1], subdural space [2], pericardium [3], pleura [4] and retroperitoneum [5], In the literature, only 2 cases of subcapsular liver hemorrhage in hemodialysis patients were reported.…”

mentioning

confidence: 99%