ArticleCase reports in nephrology2020
The Use of Pleural Fluid to Serum Glucose Ratio in Establishing the Diagnosis of a Not So Sweet PD-Related Hydrothorax: Case Report and Literature Review.
Article in Case reports in nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Pleuroperitoneal Fistula, an Unusual Case of Recurrent Unilateral Transudative Pleural Effusion.Respirology case reports · 2026Article
- Case report and review of the literature: multiplanar CT as a supportive diagnostic tool in pleuroperitoneal leak during peritoneal dialysis.Frontiers in medicine · 2026Article
- Life-Threatening Noninfectious Complications of Peritoneal Dialysis in an Infant with End-Stage Kidney Disease.Pediatric reports · 2025Article
- Pleuroperitoneal Communication following Right Hepatectomy: Successful Treatment with a Combined Thoracoscopic and Laparoscopic Approach.Surgical case reports · 2025Article
- Hydrothorax as a Complication of Peritoneal Dialysis: A Case Report.Case reports in nephrology · 2025Article
- Article
- Bilateral Pleural Effusion in Continuous Ambulatory Peritoneal Dialysis Managed by Vats Pleurodesis.European journal of case reports in internal medicine · 2024Article
- Embryological, anatomical and clinical considerations on pleuroperitoneal communication.Pleura and peritoneum · 2023Review
- Hydrothorax with Atypical Features as a Complication of Peritoneal Dialysis: A Case Report and Literature Review.The Brown journal of hospital medicine · 2023Article
- Contrast-enhanced ultrasound in peritoneal dialysis: when and how to perform it.Journal of nephrology · 2022Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hydrothorax is a well-known but rare complication of peritoneal dialysis (PD), with an average incidence of 2% mainly in cases of continuous ambulatory peritoneal dialysis (CAPD). In more than 80% of these cases, the hydrothorax is attributed to an abnormal pleuroperitoneal communication. It commonly manifests as unilateral effusion, predominantly on the right. A thoracentesis to determine pleural glucose has been a diagnostic aid well relied on, as the dextrose rich dialysate raises the pleural fluid glucose. A pleural fluid glucose to serum glucose gradient greater than 50 mg/dL is suggestive of a leak with a specificity of 100% according to some studies; however, its sensitivity is variable. Our case illustrates a diagnostic dilemma due to a relatively low pleural fluid to serum glucose gradient of 21 mg/dL that caused a delay in diagnosis. A pleural fluid to serum glucose ratio >1.0 was used as a diagnostic marker that pointed toward a peritoneal leak. For confirmation, a peritoneal scintigraphy with nuclear technetium 99 scan was performed that revealed a pleuroperitoneal fistula as the source of the recurring hydrothorax in the setting of automated peritoneal dialysis (APD). The hydrothorax completely resolved with termination of APD on follow-up as the patient was transitioned to intermittent hemodialysis (HD).
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