Uremia

In approximately 20% of patients who died from uremia, you ­ is fibrinous pleurisy . During life pain ­ fibrinous pleurisy may manifest as chaff ­ oral pain, pleural friction noise and effusion or progressive fibrosis of the pleura can cause significant ­ proper ventilation limitation . Pathogenesis porazhe ­ pleura in patients with uremia is unknown, but it is probably the same as in pericarditis, accompanied by uremia. The formation of pleural effusion and pleurisy, which organizes ventilation, is associated with the presence of hemorrhagic and constrictive pericarditis caused by uremia.

Pleural effusion is observed in 3% of patients with uremia . The relationship between the severity of uremia and probably ­ The formation of pleural effusion is not traced . More than 50% of these patients have clinical symptoms; the most frequently observed are fever (50%), pain in the chest (30%), cough (35%) and shortness of breath (20%) . Near ­ in 20% of patients, bilateral pleural effusion is formed, which can be extensive in this disease. ­nym. It has been reported that of 14 patients with uremia, I accompany ­ pleural effusion, 6 (43%) had pleural effusion more than 50% hemithorax, and one patient pleural fluid occupied the entire hemithorax, causing contralateral mediastinal shift.

Pleural fluid in patients with uremia is an exudate, in many cases serous hemorrhagic or clearly hemorrhagic . Glucose content in chaff ­ fluid is within the normal range, among leukocytes ­ lymphocytes dominate . Pleural biopsy inevitably reveals chronic fibrinous pleurisy.

The diagnosis of uremic pleurisy is extremely rare. In particular, before making this diagnosis, it is necessary to exclude fluid overload (in such cases, ­ Rally fluid will be transudate), chronic pleural ­ infection, malignant process and pulmonary embolism. As a result of dialysis, 75% of patients experience ­ gradual resorption of pleural effusion, usually in 4– b weeks . The remaining 25% of patients do not dissolve the effusion, in some cases it even increases in volume. ­ eme, and if absorbed, after some period formed again. In some cases, develop progressive quench ­ pleural cleansing, leading to restriction of ventilation and to clearly breathing difficulties . Three of these patients underwent decortication, which in no case ­ had a major bleeding . The condition of all three patients improved markedly, and in one of them after 9 month after surgery VC compared with preoperative increased from 850 to 1600 ml.Based on this data and at ­ Considering the progressive nature of uremic pleurisy, with thickening of the pleura and severe respiratory ­ Adequacy should consider decorting.

local_offerevent_note July 6, 2019

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