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Pericarditis and Pericardial Effusions in End‐Stage Renal Disease
Author(s) -
Dad Taimur,
Sarnak Mark J.
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12517
Subject(s) - medicine , pericarditis , dialysis , end stage renal disease , population , kidney disease , pericardial effusion , intensive care medicine , cardiology , surgery , disease , environmental health
Pericarditis and pericardial effusions are not uncommon in patients with end‐stage renal disease ( ESRD ). Etiologies include those found in the general population along with two entities unique to patients with kidney disease, namely uremic and dialysis‐associated pericarditis. Uremic pericarditis has been arbitrarily defined as pericarditis that develops before or within 8 weeks of initiation of dialysis, while dialysis‐associated pericarditis is used to define pericarditis in patients on dialysis for more than 8 weeks. Retention of uremic toxins is likely a major contributor to uremic and dialysis‐associated pericarditis although their exact cause is not known. Indeed, whether they are actually distinct entities is uncertain. Symptoms and signs of pericarditis differ in patients with ESRD compared to the non‐ ESRD population. Management has not been well studied and ranges from initiation and intensification of dialysis to percutaneous or open drainage for large effusions. This review covers the literature on this topic but emphasizes that most of the data are old and of relatively poor quality, and therefore additional research is needed.