A case of uremic pleuritis

Abstract

A 63 year-old female with past histories of diabetic nephropathy and unilateral nephrectomy for renal cell carcinoma was transferred to our hospital. Edema was observed in her whole body and arterial blood gas analysis showed metabolic acidosis (pH 7.247, base excess -12.3mmol/L). White blood cell counts and c-reactive protein were also increased. Chest X-ray and computed tomography showed pleural and pericardial effusion. Noninvasive positive pressure ventilation (NPPV) and renal replacement therapy (RRT) were introduced after admission. Left thoracic drainage was performed on the 3rd day and the pleural effusion was exudative with no bacteria and no malignancy. Both her blood culture and autologous antibodies were also negative. The pleural and pericardial effusion decreased and her general condition and inflammatory parameters gradually improved as RRT was continued. NPPV was removed on the 4th day, and she was transferred to the previous hospital on the 8th day. It was supposed that the cause of this course was uremic pleuritis because her pleural effusion was exudative and her condition was improved by repeated RRT. We should pay attention to this disease because it can develop in any phase of renal failure.