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[Uremic pericarditis: clinical aspects, echocardiography, therapy].
Schweizerische Medizinische Wochenschrift
|October 21, 1978
Summary
Uremic pericarditis affects chronic dialysis patients, often linked to the uremic state. Echocardiography is key for diagnosis, with steroids effectively resolving effusions in this study.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Uremic pericarditis is a known complication in patients undergoing chronic dialysis.
- The uremic state is identified as a primary contributing factor.
- Clinical presentation can range from symptomatic (chest pain, fever, friction rub) to silent.
Purpose of the Study:
- To investigate the incidence and management of uremic pericarditis in chronic dialysis patients.
- To evaluate the efficacy of different treatment modalities.
Main Methods:
- Observational study over a 2-year period.
- Included 62 patients undergoing chronic dialysis.
- Diagnostic procedures included echocardiography.
- Treatment modalities assessed: intensive hemodialysis, indomethacin, systemic or intrapericardial steroids.
Main Results:
- 11 out of 62 patients (17.7%) developed uremic pericarditis.
- Echocardiography was the most effective diagnostic tool.
- Indomethacin showed limited efficacy in reducing pericardial fluid volume (3/9 patients).
- Systemic steroid treatment led to prompt resolution of effusions in 6 patients.
- No surgical intervention was required.
Conclusions:
- Uremic pericarditis is a significant concern in chronic dialysis patients.
- Echocardiography is crucial for diagnosis.
- Systemic steroid therapy appears highly effective for managing uremic pericarditis-related effusions.
- Conservative management, including steroids, can lead to favorable outcomes without surgery.