Korean Journal of Nephrology 2001;20(1):161-165.

증례 : 혈액 투석중인 상염색체 우성 다낭성 신질환에서 발생된 요흉 1 예 (A Case of Urinothorax in Autosomal Dominant Polycystic Kidney Disease Hemodialyzed)

소미진(Mi Jin So),나병주(Byoung Ju Na),김종률(Jong Lyul Kim),이진한(Jin Han Lee),김진수(Jin Su Kim),노용호(Young Ho Rho),김태효(Tae Hyo Kim),문경협(Kyoung Hyoub Moon)

Abstract

Urinothorax is rare cause of pleural effusion. Urinothorax should be considered when pleural effusion occurs in patients with urinary tract obstruction accompanied by retroperitoneal urinoma. It has been reported in patients with trauma, malignancy, kidney biopsy and renal transplantation. Most cases are diagnosed retrospectively by promt resolution of symptoms after relief of urinary obstruction. But dia- gnosis can be made based on clinical suspicion, radiological findings and biochemical analysis of the effusion and most important finding is the pleural level of creatinine is higher than the serum level. We experienced right pleural effusion in autosomal dominant polycystic kidney disease hemodialyzed. The patient had right urinoma in the retroperitoneal space before pleural effusion developed. After 3month, he complained acute dyspnea. There was no effect in resolving effusion by lowering dry weight. We thou- ght alternative diagnostic possibility, urinothorax and checked the pleural fluid to serum creatinine ratio. Finally concluded that pleural effusion was urinothorax secondary to remnant left polycystic kidney rup- ture and tried left nephrectomy. The patient showed reduction of pleural effusion. It is important to alert physician to this condition and to avoid the other invasive diagnostic study.