Uremic pericarditis

A form of pericarditis associated with kidney failure

Uremic Pericarditis

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Fibrinous pericarditis, a form of pericarditis that can occur in uremic pericarditis.

Uremic pericarditis is a type of pericarditis that occurs in patients with chronic kidney disease or acute kidney injury. It is characterized by inflammation of the pericardium, the fibrous sac surrounding the heart, due to the accumulation of uremic toxins in the blood.

Pathophysiology

In uremic pericarditis, the buildup of uremic toxins in the blood due to impaired kidney function leads to inflammation of the pericardium. This inflammation can result in the accumulation of fluid in the pericardial space, known as a pericardial effusion. The effusion can be serous or fibrinous, with fibrinous pericarditis being more common in uremic pericarditis.

Clinical Features

Patients with uremic pericarditis may present with chest pain, which is typically sharp and pleuritic, and may be relieved by sitting up and leaning forward. Other symptoms can include fever, dyspnea, and a pericardial friction rub heard on auscultation. In severe cases, cardiac tamponade may occur, leading to hemodynamic instability.

Diagnosis

The diagnosis of uremic pericarditis is primarily clinical, supported by laboratory findings of elevated blood urea nitrogen (BUN) and creatinine levels. ECG changes may include diffuse ST segment elevation and PR segment depression. Echocardiography can be used to assess the presence and size of a pericardial effusion.

Treatment

The primary treatment for uremic pericarditis is the initiation or intensification of dialysis to remove uremic toxins. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may be used to reduce inflammation and pain. In cases of large pericardial effusion or cardiac tamponade, pericardiocentesis or surgical drainage may be necessary.

Related pages

• Pericarditis
• Chronic kidney disease
• Acute kidney injury
• Dialysis