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Uremic pericardial effusion: detection and evaluation of uremic pericardial effusion by echocardiography
Insights
Uremic pericardial effusion occurs in 62% of chronic renal failure patients undergoing hemodialysis, particularly early in therapy. Insufficient dialysis, indicated by anemia and hypertension, contributes to its development.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- Chronic renal failure (CRF) patients often develop pericardial effusion.
- Hemodialysis is a common treatment for CRF, but can be associated with complications.
- Uremic pericardial effusion is a significant concern in this population.
Purpose of the Study:
- To detect and volumetrically grade pericardial effusion in CRF patients undergoing hemodialysis.
- To investigate the incidence and influencing factors of uremic pericardial effusion.
- To correlate effusion grade with clinical and laboratory parameters.
Main Methods:
- Echocardiography (UCG) performed before and during hemodialysis in 150 CRF patients.
- Classification of pericardial effusion from grade 0 to 5.
- Comparison of effusion grade with laboratory results, blood pressure, and cardiac dimensions.
Main Results:
- Incidence of uremic pericardial effusion was 62%, higher in the first 3 months of therapy.
- Significant differences in systolic hypertension, left atrial dilatation, anemia, and hypoproteinemia between patients with and without effusion.
- No correlation found between effusion grade and creatinine, uric acid, calcium, or body weight changes.
Conclusions:
- Insufficient dialysis, evidenced by hypoproteinemia, anemia, hypertension, and overhydration, is implicated in the etiology of uremic pericardial effusion.
- Echocardiography is crucial for evaluating pericardial effusion in hemodialysis patients.
- Early detection and management of factors contributing to uremic pericardial effusion are important.
Abstract:
Echocardiography (UCG) was performed prior to and during hemodialysis therapy to detect and evaluate volumetrically the grade of pericardial effusion in 150 patients with chronic renal failure. The actual incidence of uremic pericardial effusion during the observation period was 62% and was higher during the first 3 months of therapy than at later stages. Pericardial effusion was classified from grade 0 (no effusion) to grade 5 (massive effusion). We compared the grade of effusion with laboratory test results, blood pressure, cardiothoratic ratio, left atrial and ventricular dimensions, and thickness of the intraventricular septum and left ventricular posterior wall. Significant differences between the patients with and without effusion were detected in the degree of systolic hypertension, dilatation of the left atrial chamber, anemia and hypoproteinemia. There was no correlation between the grade of effusion and creatinine, uric acid and calcium levels and changes of body weight. Our results confirm that insufficient dialysis as indexed by the degree of hypoproteinemia, anemia, hypertension and central overhydration, may play a role in the etiology of uremic pericardial effusion.