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Abstract：
OBJECTIVE: Pericardial effusion (PE) is a prevalent form of pericardial involvement in chronic kidney disease (CKD). This study aims to investigate the clinical and laboratory features associated with PE severity in patients with CKD.
METHODS: In this cross-sectional study, we examined the medical records of patients admitted to tertiary hospitals with International Classification of Diseases 10th Revision (ICD-10) codes associated with CKD and PE. We included 112 CKD patients in stage 4 and 5 non-dialysis (ND) with PE for assessing the clinical and laboratory features of severity.
RESULTS: Patients were divided into two categories based on the severity of PE. Seventy-two patients had mild and 40 had moderate and severe PE. Univariate analysis of demographic and laboratory features on the date of admission demonstrated that chest pain, dyspnea, serum albumin, and neutrophil-to-lymphocyte ratio (NLR) are associated with the severity of PE. The univariate analysis on the date of echocardiography showed significantly higher white blood cell count (WBC), neutrophil count (percentage and absolute count), and NLR, along with significantly lower lymphocyte percentage and serum albumin among patients with moderate and severe PE. In the multivariable analysis of laboratory features, on admission hypoalbuminemia (p-value = 0.014, OR = 4.03, CI: 1.32-12.25) and NLR greater than 5.5 (p-value = 0.015, OR = 4.22, CI: 1.32-13.50) were significantly associated with moderate and severe PE. In a parallel matter, at the time of echocardiography hypoalbuminemia (p-value = 0.004, OR = 5.38, CI: 1.74-16.65) and neutrophilia (p-value = 0.005, OR = 7.94, CI: 1.89-33.44) were significantly associated with moderate and severe PE.
CONCLUSIONS: Despite advancements in the diagnosis and treatment of CKD, PE is still a concerning issue in these patients. This study revealed that hypoalbuminemia, neutrophilia, and NLR greater than 5.5 could be predictive factors of moderate and severe PE in CKD patients with PE. Further prospective study with larger sample size is needed to confirm these results.
METHODS: In this cross-sectional study, we examined the medical records of patients admitted to tertiary hospitals with International Classification of Diseases 10th Revision (ICD-10) codes associated with CKD and PE. We included 112 CKD patients in stage 4 and 5 non-dialysis (ND) with PE for assessing the clinical and laboratory features of severity.
RESULTS: Patients were divided into two categories based on the severity of PE. Seventy-two patients had mild and 40 had moderate and severe PE. Univariate analysis of demographic and laboratory features on the date of admission demonstrated that chest pain, dyspnea, serum albumin, and neutrophil-to-lymphocyte ratio (NLR) are associated with the severity of PE. The univariate analysis on the date of echocardiography showed significantly higher white blood cell count (WBC), neutrophil count (percentage and absolute count), and NLR, along with significantly lower lymphocyte percentage and serum albumin among patients with moderate and severe PE. In the multivariable analysis of laboratory features, on admission hypoalbuminemia (p-value = 0.014, OR = 4.03, CI: 1.32-12.25) and NLR greater than 5.5 (p-value = 0.015, OR = 4.22, CI: 1.32-13.50) were significantly associated with moderate and severe PE. In a parallel matter, at the time of echocardiography hypoalbuminemia (p-value = 0.004, OR = 5.38, CI: 1.74-16.65) and neutrophilia (p-value = 0.005, OR = 7.94, CI: 1.89-33.44) were significantly associated with moderate and severe PE.
CONCLUSIONS: Despite advancements in the diagnosis and treatment of CKD, PE is still a concerning issue in these patients. This study revealed that hypoalbuminemia, neutrophilia, and NLR greater than 5.5 could be predictive factors of moderate and severe PE in CKD patients with PE. Further prospective study with larger sample size is needed to confirm these results.
摘要：
目的：心包积液（PE）是慢性肾脏病（CKD）中心包受累的一种常见形式。本研究旨在探讨CKD患者与PE严重程度相关的临床和实验室特征。
方法：在这项横断面研究中，我们检查了与CKD和PE相关的国际疾病分类第10版(ICD-10)代码的三级医院住院患者的病历.我们纳入了112例慢性肾脏病（CKD）4期和5期非透析（ND）患者，用于评估严重程度的临床和实验室特征。
结果：根据PE的严重程度将患者分为两类。72例患者患有轻度PE，40例患有中度和重度PE。入院日期的人口统计学和实验室特征的单变量分析表明胸痛，呼吸困难,血清白蛋白,中性粒细胞与淋巴细胞比值（NLR）与PE的严重程度有关。超声心动图当天的单因素分析显示白细胞计数（WBC）明显增高，中性粒细胞计数（百分比和绝对计数），和NLR，在中度和重度PE患者中，淋巴细胞百分比和血清白蛋白显着降低。在实验室特征的多变量分析中，入院时低蛋白血症（p值=0.014，OR=4.03，CI：1.32-12.25）和NLR大于5.5（p值=0.015，OR=4.22，CI：1.32-13.50）与中度和重度PE显着相关。在一个平行的问题上，超声心动图检查时低白蛋白血症(p值=0.004,OR=5.38,CI:1.74~16.65)和中性粒细胞增多(p值=0.005,OR=7.94,CI:1.89~33.44)与中度和重度PE显著相关.
结论：尽管CKD的诊断和治疗取得了进展，在这些患者中，PE仍然是一个令人担忧的问题。这项研究显示低蛋白血症,嗜中性粒细胞增多症,NLR大于5.5可能是CKD合并PE患者中重度PE的预测因素。需要更大样本量的进一步前瞻性研究来证实这些结果。
方法：在这项横断面研究中，我们检查了与CKD和PE相关的国际疾病分类第10版(ICD-10)代码的三级医院住院患者的病历.我们纳入了112例慢性肾脏病（CKD）4期和5期非透析（ND）患者，用于评估严重程度的临床和实验室特征。
结果：根据PE的严重程度将患者分为两类。72例患者患有轻度PE，40例患有中度和重度PE。入院日期的人口统计学和实验室特征的单变量分析表明胸痛，呼吸困难,血清白蛋白,中性粒细胞与淋巴细胞比值（NLR）与PE的严重程度有关。超声心动图当天的单因素分析显示白细胞计数（WBC）明显增高，中性粒细胞计数（百分比和绝对计数），和NLR，在中度和重度PE患者中，淋巴细胞百分比和血清白蛋白显着降低。在实验室特征的多变量分析中，入院时低蛋白血症（p值=0.014，OR=4.03，CI：1.32-12.25）和NLR大于5.5（p值=0.015，OR=4.22，CI：1.32-13.50）与中度和重度PE显着相关。在一个平行的问题上，超声心动图检查时低白蛋白血症(p值=0.004,OR=5.38,CI:1.74~16.65)和中性粒细胞增多(p值=0.005,OR=7.94,CI:1.89~33.44)与中度和重度PE显著相关.
结论：尽管CKD的诊断和治疗取得了进展，在这些患者中，PE仍然是一个令人担忧的问题。这项研究显示低蛋白血症,嗜中性粒细胞增多症,NLR大于5.5可能是CKD合并PE患者中重度PE的预测因素。需要更大样本量的进一步前瞻性研究来证实这些结果。
