Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients: Presentation of two cases and a review of the literature

Nima Momenin, Patrick M. Colletti, Elaine M. Kaptein

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10% of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after initiating PD was <3 months in only 48%. Shortness of breath was reported in 96%. Pleural effusions were right sided in 87%. Pleural fluid-to-serum glucose gradients varied from 2 to 1885 mg/ dL, with 20% ≤50 mg/dL, 13% being 51-100 and 67% >100 mg/dL. All pleural fluid-to-serum glucose ratios were >1.Conclusions. With a transudative pleural effusion in patients receiving PD, a pleural fluid-to-serum glucose ratio >1 is consistent with a pleuroperitoneal communication. In questionable cases, independent verification is necessary.

Original languageEnglish (US)
Pages (from-to)1212-1219
Number of pages8
JournalNephrology Dialysis Transplantation
Volume27
Issue number3
DOIs
StatePublished - May 1 2012
Externally publishedYes

Fingerprint

Peritoneal Dialysis
Communication
Glucose
Pleural Effusion
Serum

Keywords

  • Glucose gradient
  • Hydrothorax
  • Pleural effusion
  • Pleuroperitoneal communication
  • Scintigraphy

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients : Presentation of two cases and a review of the literature. / Momenin, Nima; Colletti, Patrick M.; Kaptein, Elaine M.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 3, 01.05.2012, p. 1212-1219.

Research output: Contribution to journalReview article

@article{b78c658de83e4c03bdabed35d80afb36,
title = "Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients: Presentation of two cases and a review of the literature",
abstract = "Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10{\%} of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after initiating PD was <3 months in only 48{\%}. Shortness of breath was reported in 96{\%}. Pleural effusions were right sided in 87{\%}. Pleural fluid-to-serum glucose gradients varied from 2 to 1885 mg/ dL, with 20{\%} ≤50 mg/dL, 13{\%} being 51-100 and 67{\%} >100 mg/dL. All pleural fluid-to-serum glucose ratios were >1.Conclusions. With a transudative pleural effusion in patients receiving PD, a pleural fluid-to-serum glucose ratio >1 is consistent with a pleuroperitoneal communication. In questionable cases, independent verification is necessary.",
keywords = "Glucose gradient, Hydrothorax, Pleural effusion, Pleuroperitoneal communication, Scintigraphy",
author = "Nima Momenin and Colletti, {Patrick M.} and Kaptein, {Elaine M.}",
year = "2012",
month = "5",
day = "1",
doi = "10.1093/ndt/gfr393",
language = "English (US)",
volume = "27",
pages = "1212--1219",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients

T2 - Presentation of two cases and a review of the literature

AU - Momenin, Nima

AU - Colletti, Patrick M.

AU - Kaptein, Elaine M.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10% of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after initiating PD was <3 months in only 48%. Shortness of breath was reported in 96%. Pleural effusions were right sided in 87%. Pleural fluid-to-serum glucose gradients varied from 2 to 1885 mg/ dL, with 20% ≤50 mg/dL, 13% being 51-100 and 67% >100 mg/dL. All pleural fluid-to-serum glucose ratios were >1.Conclusions. With a transudative pleural effusion in patients receiving PD, a pleural fluid-to-serum glucose ratio >1 is consistent with a pleuroperitoneal communication. In questionable cases, independent verification is necessary.

AB - Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10% of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after initiating PD was <3 months in only 48%. Shortness of breath was reported in 96%. Pleural effusions were right sided in 87%. Pleural fluid-to-serum glucose gradients varied from 2 to 1885 mg/ dL, with 20% ≤50 mg/dL, 13% being 51-100 and 67% >100 mg/dL. All pleural fluid-to-serum glucose ratios were >1.Conclusions. With a transudative pleural effusion in patients receiving PD, a pleural fluid-to-serum glucose ratio >1 is consistent with a pleuroperitoneal communication. In questionable cases, independent verification is necessary.

KW - Glucose gradient

KW - Hydrothorax

KW - Pleural effusion

KW - Pleuroperitoneal communication

KW - Scintigraphy

UR - http://www.scopus.com/inward/record.url?scp=84861168854&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861168854&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfr393

DO - 10.1093/ndt/gfr393

M3 - Review article

C2 - 21771760

AN - SCOPUS:84861168854

VL - 27

SP - 1212

EP - 1219

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 3

ER -