[Pericarditis and heart tamponade in patients on regular hemodialysis]

Among 137 patients with terminal renal failure maintained on chronic haemodialysis, pericarditis was found in 37. In 11 cases it developed prior to the onset of haemodialysis therapy, and in 26 during various periods within the therapeutic course. In patients maintained on haemodialysis pericarditis is characterized by a protracted course, severe pain syndrome, ability to cause or intensify cardiac failure, to produce cardiac rhythm disorders. In 15 patients pericarditis was complicated by a massive effusion into the pericardiac cavity. In 3 of them the effusion gradually dissolved, 3 other ultimately developed subacute constrictive pericarditis, in the remaining 9 the effusion resulted in tamponade. Two patients died of cardiac tamponade, in the remaining 7 patients 12 transdiaphragmal pericardial punctures were performed. In 2 cases the latter caused severe complications. The discussion deals with the methods of treatment of pericarditis in patients on chronic haemodialysis, with the preventive measures against the effusion, and the means of its management.