Uremic pericarditis. Clinical features and management

Uremic pericarditis occurred in 41% of 83 patients admitted to the chronic dialysis program at the Peter Bent Brigham Hospital. In the vast majority of these patients the pericarditis was present before dialysis and cleared clinically after beginning therapy. Instances of pericarditis that developed during regular dialysis were associated with metabolic stress such as surgery or infection or inadequate dialysis. When the pericarditis failed to resolve the patients usually died with sepsis or had severe tamponade which necessitated early pericardiectomy. The two cases reported illustrate resorption of massive pericardial effusions with dialysis. The utility of percutaneous pericardial catheterization as a treatment for uremic pericardial tamponade is demonstrated.