{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:09:17Z","timestamp":1784696957501,"version":"3.55.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T00:00:00Z","timestamp":1717632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and aims<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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\u201312.25) and NLR greater than 5.5 (p-value = 0.015, OR = 4.22, CI: 1.32\u201313.50) 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\u201316.65) and neutrophilia (p-value = 0.005, OR = 7.94, CI: 1.89\u201333.44) were significantly associated with moderate and severe PE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302200","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T17:53:50Z","timestamp":1717696430000},"page":"e0302200","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pericardial effusion in patients with chronic kidney disease: A two-center study"],"prefix":"10.1371","volume":"19","author":[{"given":"Vahid","family":"Eslami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0891","authenticated-orcid":true,"given":"SeyedehFatemeh","family":"Mousavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-329X","authenticated-orcid":true,"given":"Rana","family":"Irilouzadian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hediyeh","family":"Baghsheikhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrdad Jafari","family":"Fesharaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6707-7844","authenticated-orcid":true,"given":"Shiva","family":"Samavat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"issue":"10","key":"pone.0302200.ref001","doi-asserted-by":"crossref","first-page":"e0258494","DOI":"10.1371\/journal.pone.0258494","article-title":"Burden of chronic kidney disease in the general population and high-risk groups in South Asia: A systematic review and meta-analysis.","volume":"16","author":"N Shrestha","year":"2021","journal-title":"PLOS ONE."},{"issue":"42","key":"pone.0302200.ref002","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS).","volume":"36","author":"Y Adler","year":"2015","journal-title":"European heart journal"},{"key":"pone.0302200.ref003","first-page":"169","article-title":"Uremic pericarditis: a report of 30 cases and review of the literature","volume":"16","author":"SA Sadjadi","year":"2015","journal-title":"The American journal of case reports"},{"issue":"5","key":"pone.0302200.ref004","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/sdi.12517","article-title":"Pericarditis and Pericardial Effusions in End-Stage Renal Disease.","volume":"29","author":"T Dad","year":"2016","journal-title":"Semin Dial."},{"issue":"9","key":"pone.0302200.ref005","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.echo.2013.06.023","article-title":"American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography.","volume":"26","author":"AL Klein","year":"2013","journal-title":"J Am Soc Echocardiogr."},{"issue":"10","key":"pone.0302200.ref006","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1016\/j.amjmed.2016.05.043","article-title":"A Silent Relic: Uremic Pericardial Effusion","volume":"129","author":"MA Santos","year":"2016","journal-title":"The American journal of medicine"},{"issue":"5","key":"pone.0302200.ref007","first-page":"994","article-title":"The importance of echocardiographic evaluation of pericardial effusion associated with mitral valve pseudoprolapse in patients with chronic renal failure.","volume":"22","author":"B Zahiti","year":"2011","journal-title":"Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia"},{"issue":"6","key":"pone.0302200.ref008","first-page":"596","volume":"42","author":"KW Chang","year":"2015","journal-title":"Pericardial Effusion in Patients with End-Stage Renal Disease. 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