Level of Conformity Examination of Uric Acid Levels in Pleural Fluid, Ratio of Uric Acid Levels in Pleural Fluid with Serum to Distinguish Exudates and Transudates

Indarto Sigit, Yusup Subagio Sutanto, Harsini Harsini

Abstract


Background: Uric acid can be used as a biomarker to distinguish transudates from pleural fluid exudates. Uric acid is soluble in liquid media, elevated levels of uric acid in blood plasma become a predisposing factor for uric crystal deposits in tissues and body fluids. Increased permeability due to changes in capillary pleural pressure in the formation of transudates is a cause of increased levels of uric acid in pleural fluid. The aim of the study was to analyze the examination of pleural fluid uric acid levels and the ratio of uric acid levels to pleural fluid to serum to distinguish exudates and transudates in pleural effusion.
Methods: A cross sectional diagnostic test with a cross sectional study design in pleural effusion patients at RSUD Dr. Moewardi Surakarta in July-August 2019. Subjects were examined for pleural fluid levels, serum uric acid ratio, and pleural fluid analysis.
Results: A total of 30 pleural effusion patients were included in this study. The level of agreement between the uric acid pleural fluid against Light criteria was in the moderate category and statistically significant (Kappa = 0.595; P=0.001). The level of agreement between the ratio of uric acid to pleural fluid and serum to Light's criteria was weak and not statistically significant (Kappa = 0.200; p = 0.195)
Conclusion: The level of concordance between pleural fluid uric acid with Light criteria is in the medium category and statistically significant. There is no match between the ratio of serum pleural fluid uric acid levels with Light criteria. (J Respir Indo. 2020; 40(2): 82-6)

Keywords


uric acid serum, pleural effusion

References


Maskell NA, Butland R. BTS guidelines for the investigation of a unilateral pleural effusion in adults. Thorax. 2003;58:8-17.

Porcel JM. Identifying transudates misclassified by Light’s criteria. Curr Opin Pulm Med. 2013;19:362-67.

De Oliveira EP, Burini RC. High plasma uric acid concentration: Causes and consequences. Diabetol Metab Syndr. 2012;4:1-7.

Hartono SW, Sennang N, Mangarengi F. Diagnostic value of uric acid in pleural effusion. Indones J Clin Pathol Med Lab. 2018;24:146-150.

Yalcin NG, Choong CKC, Eizenberg N. Anatomy and pathophysiology of the pleura and pleural space. Thorac Surg Clin. 2013;23:1-10.

Peng M-J, Wang N-S. Anatomy of the pleura. In: Bouros D, ed. Pleural Disease. New York: Marcel Dekker, Inc.; 2004:23-40.

Decramer EM, Rossi A, Antony VB. Immunological mechanisms in pleural disease. Eur Respir J. 2003;21:539-44.

Pratomo IP, Yunus F. Anatomi dan fisiologi pleura. CDK-205. 2013;40:407-12.

Light RW. Physiology of the pleural space. In: Light RW, ed. Pleural Diseases. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2013:8-19.

Light RW. The Light Criteria: The Beginning and Why they are Useful 40 Years Later. Clin Chest Med. 2013;34:21-6.

Broaddus VC, Light RW. Pleural effusion. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray and Nadel’s Textbook of Respiratory Medicine. fifth. philadelphia: Elsevier Saunders; 2010:1719-63.

Heffner JE. Nonmalignant pleural effusions. In: Grippi MA, Elias JA, Fishman JA, Kotloff robert M, Pack A i., Senior robert M, eds. Fishman’s Pulmonary Diseases and Disorders. Fifth Edit. new york: McGraw-Hill Education; 2015:1168-1187.

Light RW. Approach to the patient. In: Light RW, ed. Pleural Disease. 6th ed. philadelphia: Lippincott Williams & Wilkins; 2013:128-39.

Heffner JE. Discrimination between transudative and exudative pleural effusions. In: Bouros D, ed. Pleural Disease. New York: Marcel Dekker, Inc.; 2004:237-52.

Jain A, Kumar S, Jain R, B Petkar S, Khare N. A study of uric acid - a new biochemical marker for the differentiation between exudates and transudates in a pleural effusion cases. Natl J Community Med. 2015;5:204-8..




DOI: https://doi.org/10.36497/jri.v40i2.100

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Jurnal Respirologi Indonesia
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