Understanding Hemodialysis-Associated Pericarditis: Causes, Symptoms, and Management Strategies

Hemodialysis-associated pericarditis is a significant but insufficiently acknowledged complication in patients with end-stage renal disease (ESRD). It can manifest as either uremic pericarditis, typically occurring before or shortly after the initiation of dialysis, or dialysis-associated pericarditis, which results from prolonged dialysis treatment. The condition is associated with substantial morbidity and potential mortality due to risks, such as cardiac tamponade and constrictive pericarditis. Pericardial involvement in ESRD most frequently presents as acute uremic or dialysis-associated pericarditis, whereas chronic constrictive pericarditis represents a less common manifestation. The aim of the article is to review the current understanding of the epidemiology, pathophysiology, clinical presentation, diagnostic criteria and therapy strategies of this pathology based on a case of hemodialysis-associated pericarditis in a patient diagnosed with sudden shortness of breath during a hemodialysis session. When assessing pericarditis in this group of population, it is recommended to distinguish between uremic and dialysis-associated forms, to recognize clinical warning signs, and to customize the treatment. Probably the therapy should include anti-inflammatory drugs, colchicine, intensified dialysis, and in severe cases, even pericardiocentesis or surgical intervention. Rising awareness and timely intervention are critical to improve outcomes in this vulnerable population.