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Pericardial involvement in end stage renal disease

  • Chapter
Pericardial Disease

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 108))

Abstract

Our definition of pericardial involvement in end stage renal disease includes all types of pericardial disease in uremic patients, whether or not they have started any modality of dialysis. We therefore agree that the term uremic pericarditis should be reserved for pericardial involvement in advanced uremia, assuming that pericardial disease in patients on hemodialysis might have a different etiology and pathogenesis (1, 2). Uremic pericarditis is an example of the changes brought about by the advances in medicine in the incidence, clinical presentation and outcome of several diseases. The response of the pericardium to far advanced uremia, in the form of a fibrinous exudate with adhesion between the two layers and invasion and organization of the space between them has long been known as a complication that often heralds death (3–6). Its evolution to cardiac tamponade was considered to be exceptional (7), probably because the patients died without the benefit of dialysis. The introduction of dialysis has modified the history of this condition, reducing the incidence of uremic pericarditis while resulting in the more common development of tamponade. Usually, tamponade develops during the dialysis session or immediately afterwards (8–15). This condition, which is potentially lethal, has given rise to a variety of therapeutic approaches ranging from intensification of dialysis (12, 14, 16) to drainage of pericardial effusion (8, 9, 12, 14, 16–22).

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References

  1. Renfrew R, Buselmeier TJ, Kjellstrand CM. Pericarditis and renal failure. Ann Rev Med 1980; 31:345–360.

    Article  PubMed  CAS  Google Scholar 

  2. Shabetai R, Rostand SG. Nephrogenic pericardial disease. In: O’Rourke RA, Brenner BM, Stein JH, ed. The heart and renal disease. New York, Churchill Livingstone 1984; 89–125.

    Google Scholar 

  3. Bright R. Tubular view of the morbid appearances in 100 cases connected with albuminous urine: with observations. Guy’s Hosp Rep 1836; 1:388–400.

    Google Scholar 

  4. Barach AL, Pericarditis in chronic nephritis. Am J Med Sci 1922; 163:44–60.

    Article  Google Scholar 

  5. Richter A, O’Hara J. The heart in chronic glomerular nephritis. N Engl J Med 1936; 214:824–830.

    Article  Google Scholar 

  6. Wacker W, Merrill J. Uremic pericarditis in acute and chronic renal failure. JAMA 1954; 156:764–765.

    CAS  Google Scholar 

  7. Goodner C, Brown H. Report of two cases of cardiac tamponade in uremic pericarditis. JAMA 1956; 162:1.459–1.461.

    Google Scholar 

  8. Hager E. Clinical observations on five patients with uremic pericardial tamponade. N Engl J Med 1965; 273:304–308.

    Article  PubMed  CAS  Google Scholar 

  9. Beaudry C, Nakamoto S, Kolf WJ. Uremic pericarditis and cardiac tamponade in chronic renal failure. Ann Intern Med 1966; 64:990–995.

    PubMed  CAS  Google Scholar 

  10. Bailey G, Hampers C, Hager E, Merrill J. Uremic pericarditis. Circulation 1968; 38:582–591.

    PubMed  CAS  Google Scholar 

  11. Alfrey AC, Goss JE, Ogden DA, Vogel JHK, Holmes JH. Uremic hemopericardium. Am J Med 1968; 45:391–400.

    Article  PubMed  CAS  Google Scholar 

  12. Comty CM, Cohen SL, Shapiro FL. Pericarditis in chronic uremia and its sequels. Ann Intern Med 1971; 75:173–183.

    PubMed  CAS  Google Scholar 

  13. Baldwin JJ, Edwards JE. Uremic pericarditis as a cause of cardiac tamponade. Circulation 1976; 53:896–901.

    PubMed  CAS  Google Scholar 

  14. Sevillano R, González V, Tejuca F, Fernández E, Martínez J. El diagnóstico precoz de la pericarditis aguda en las unidades de diálisis. Med Clin (Bare) 1977; 68:331–334.

    Google Scholar 

  15. Carreras L, Caseiro G, Griño JM, Martínez A, Poveda R. Pericarditis en la insuficiencia renal crónica. Rev Soc Esp Dial Trasp 1979; 1:27–29.

    Google Scholar 

  16. Silverberg S, Oreopoulus DG, Wise DJ, Uden DE, Meindok H, Jones M, Rapoport A, de Veber GA. Pericarditis in patients undergoing long—term hemodialysis and peritoneal dyalisis. Incidence, complications and management. Am J Med 1977; 63:8742–879.

    Article  Google Scholar 

  17. Buselmeier TJ, Simmons RL, Najarían JS, Maver SM, Matas AJ, Kjellstrand CM. Uremic pericardial effusion. Nephron 1976; 16:371–380.

    Article  PubMed  CAS  Google Scholar 

  18. Sánchez Lloret J, Capdevila J, Zurita M, Saura E. La pericardiectomía como tratamiento del taponamiento cardíaco en las pericarditis urémicas en curso de diálisis. Med Clin (Barc) 1973; 60:132–143.

    Google Scholar 

  19. Ali-Regiaba S, White RP, Gay WA, Stenzel KH, Sullivan JF, Riggio RR, Tapia L., Cheigh JS, David DS, Rubin AL. Treatment of uremic pericarditis by anterior pericardiectomy. Lancet 1974; 2:12–14.

    Article  PubMed  CAS  Google Scholar 

  20. Wray TM, Humphreys J, Perry JM, Stone WJ, Bender HW. Pericardiectomy for treatment of uremic pericarditis. Circulation 1974; S-II 49–50:268–271.

    Google Scholar 

  21. Valles M, Torras A, Darnell A, Letang E, Sánchez Lloret J, Pascual R, Montoliu J, Revert L. Segmental pericardiectomy in the treatment of uremic pericarditis. Dial & Transplant 1981; 10: 432 – 436.

    Google Scholar 

  22. Leehey DJ, Daugirdas JT, Ing TS. Early drainage of pericardial effusion in patients with dialysis pericarditis. Arch Intern Med 1983; 143:1.673–1.675.

    Article  Google Scholar 

  23. Goldstein DH, Hagar CH, Srivastara N, Schacht RA, Ferris FZ, Flowers NC. Clinically silent pericardial effusions in patients on long—term hemodialysis. Chest 1977;72:744–747.

    Article  PubMed  CAS  Google Scholar 

  24. Horton JD, Gelfand MC, Sherber HS. Natural history of asymptomatic pericardial effusions in patients on maintenance hemodialysis. Proc Dial Transplant Forum 1977;76–81.

    Google Scholar 

  25. Kleiman JH, Motta J, London E, Pennell JR, Popp RL. Pericardial effusions in patients with end—stage disease. Br Heart J 1978; 40:190–193.

    Article  PubMed  CAS  Google Scholar 

  26. Frommer JP, Young JB, Ayus JC. Asymptomatic pericardial effusion in uremic patients: effect of long term dialysis. Nephron 1985; 39:296–301.

    Article  PubMed  CAS  Google Scholar 

  27. Wray TM, Stone WJ. Uremic pericarditis: a prospective echocardiographic and clinical study. Clin Nephrol 1976; 6:295–302.

    PubMed  CAS  Google Scholar 

  28. Winney RJ, Wright N, Sumerling MD, Lambie AT. Echocardiography in uremic pericarditis with effusion. Nephron 1977; 18:201–207.

    Article  PubMed  CAS  Google Scholar 

  29. Luft FC, Gilman JK, Weyman AE. Pericarditis in the patients with uremia: clinical and echocardiographic evaluation. Nephron 1980; 25:160–166.

    Article  PubMed  CAS  Google Scholar 

  30. Yoshida K, Shiina A, Asano Y, Hosoda S. Uremic pericardial effusion: detection and evaluation of uremic pericardial effusion by echocardiography. Clin Nephrol 1980; 13:260–268.

    PubMed  CAS  Google Scholar 

  31. Comty CM, Wathen RL, Shapiro FL. Uremic pericarditis. In: Spodick DH, ed. Pericardial diseases. Philadelphia, FA Davis, 1976;219–235.

    Google Scholar 

  32. Drüeke T, le Pailleur C, Jungers P. Cardiomyopathie et pericardite urémiques. In: Hamburger J, Crosnier J, Funck-Bretano JL, ed. Actualités nephrologiques de l’Hôpital Necker. Paris, Flamarion, 1979; 37–70.

    Google Scholar 

  33. Shabetai R. The pericardium. New York, Grune & Stratton, 1981; 385–389.

    Google Scholar 

  34. Kotler MN, Parry WR. Pericardial disease in chronic renal failure. In: Lowenthal DT, Pennock RS, Likoff W, Onesti G, eds. Management of the cardiac patient with renal failure. Philadelphia, FA Davis, 1981; 85–109.

    Google Scholar 

  35. Comty CM, Shapio FL. Cardiac complications of regular dialysis therapy. In: Drukker W, Parsons FM, Maher JF, eds. Replacement of renal function by dialysis. Boston, Martinus Nijhoff, 1983; 595–610.

    Google Scholar 

  36. Rutsky EA, Rostand SG. Treatment of uremic pericarditis and pericardial effusion. Am J Kid Dis 1987; 10:2–8.

    PubMed  CAS  Google Scholar 

  37. Galve E, García del Castillo H, Evangelista A, Batlle J, Permanyer-Miralda G, Soler-Soler J. Pericardial effusion in the course of myocardial infarction: incidence, natural history, and clinical relevance. Circulation 1986; 73:294–299.

    Article  PubMed  CAS  Google Scholar 

  38. Babb AL, Johansen PJ, Strand M J, Tenckhoff H, Scribner BH. Bidirectional permeability of the human peritoneum to middle molecules. Proc Eur Dial Transpl Assoc 1973; 10:247–251.

    CAS  Google Scholar 

  39. Bergström J, Fürst P. Uremic middle molecules. Clin Nephrol 1976; 5:143–149.

    PubMed  Google Scholar 

  40. Cochran M, Lawton S, Rowlands LM. Fibrinous pericarditis and fibrinolysis in chronic dialysis patients. Clin Nephrol 1979; 11:23–25.

    PubMed  CAS  Google Scholar 

  41. Pabico RC, Nanshaw JB, Talley TE. Cytomegalovirus infection in chronic hemodialysis patients. Abstr West Dial and Transplant Soc 1971; 1:117–123.

    CAS  Google Scholar 

  42. Osanloo E, Salhorb RJ, Cioffi RF, Parker RH. Viral pericarditis in patients receiving hemodialysis. Arch Intern Med 1979; 139:301–303.

    Article  PubMed  CAS  Google Scholar 

  43. Morlans M, Ballester M, Bartolomé J, Permanyer G, Olmos A, Piera L. Diagnóstico y tratamiento de la pericarditis en pacientes urémicos. Med Clin (Barc) 1981; 77:269–273.

    CAS  Google Scholar 

  44. Dave MB, Choi YJ, Cohen BD. Hepatitis B virus: A possible cause of serositis in hemodialysis patients. Nephron 1983; 33:186–188.

    Article  PubMed  CAS  Google Scholar 

  45. Joffe P, Johannessen AC. Uraemic pericarditis, an epidemic disease? Dan Med Bull 1987; 34:117–118.

    PubMed  CAS  Google Scholar 

  46. Permanyer-Miralda G, Sagristà-Sauleda J, Soler-Soler J. Primary acute pericardial disease: A prospective series of 231 consecutive patients. Am J Cardiol 1985; 56:623–630.

    Article  PubMed  CAS  Google Scholar 

  47. Twardowski ZJ, Alpert MA, Gupta RC, Nolph KD, Madsen BT. Circulating inmune complexes: Possible toxins responsible for serositis (pericarditis, pleuritis and peritonitis) in renal failure. Nephron 1983; 35:190–195.

    Article  PubMed  CAS  Google Scholar 

  48. Maisch B, Kochsiek K. Humoral inmune reactions in uremic pericardits. Am J Nephrol 1983; 3:264–271.

    Article  PubMed  CAS  Google Scholar 

  49. Ahmad R, Goldsmith HJ. Response of pericardial effusion to ultrafiltration and intensified hemodialysis. Dial Transplant 1977; 6:12.

    Google Scholar 

  50. Morlans M. Pericarditis urèmica. Med Clin (Barc) 1983; 80:263–264.

    CAS  Google Scholar 

  51. Morlans M, Vallés M, Larrousse E. Asociación de derrame pleural izquierdo y enfermedad pericárica en el paciente urèmico. Nefrología 1986; 6:53–56.

    Google Scholar 

  52. Weiss JM, Spodick DH. Association of left pleural effusion with pericardial disease. N Engl J Med 1983; 308:696–697.

    Article  PubMed  CAS  Google Scholar 

  53. Hancock EW. Cardiac tamponade. Med Clin N Am 1979; 63:223–237.

    PubMed  CAS  Google Scholar 

  54. Morlans M, Ballester M, Camps J, Sans A, Permanyer G, Olmos A. Diagnóstico y tratamiento del taponamiento cardíaco secundario a pericarditis en pacientes hemodializados. Rec Soc Esp Dial Transplant 1981; 3:93–98.

    Google Scholar 

  55. Ports TA, Botvinick EH, Schiller NB, Miller SW, Silverman NH, Chatterjee K. Diagnóstico no invasivo del taponamiento cardÍaco. Cardiovascular Rev Rep (ed. esp.) 1981; 2:23–29.

    Google Scholar 

  56. Reddy PS, Curtiss EI, O’Toole JD, Shaver JA. Cardiac tamponade: hemodynamic observations in man. Circulation 1978; 58:265–272.

    PubMed  CAS  Google Scholar 

  57. D’Cruz IA, Cohen HC, Prabhu R. Diagnosis of cardiac tamponade by echocardiography: changes in mitral valve motion and ventricular dimensions, with special reference to paradoxical pulse. Circulation 1975; 52:460–465.

    PubMed  Google Scholar 

  58. Schiller NB, Botvinick EH. Right ventricular compression as a sign of cardiac tamponade. An analysis of echocardiographic ventricular dimensions and their clinical implications. Circulation 1977; 56:774–779.

    PubMed  CAS  Google Scholar 

  59. Engel PJ. Echocardiographic findings in pericardial disease. In: Fowler NO, ed. The pericardium in health and disease. New York, Futura Publishing Co., 1985; 99–151.

    Google Scholar 

  60. Shabetai R, Fowler NO, Guntheroth WG. The hemodynamics of cardiac tamponade and constrictive pericarditis. Am J Cardiol 1970; 26:480–489.

    Article  PubMed  CAS  Google Scholar 

  61. Ballester M, Serra A, Angel J, Carcia del Castillo H, Morlans M. Derrame pericárdico localizado con taponamiento cardíaco en un enfermo con insuficiencia renal crónica en programa de hemodiálisis. Med Clin (Barc) 1982; 78:99–103.

    CAS  Google Scholar 

  62. Lindsay J Jr, Crawley IS, Callaway GM. Chronic constrictive pericarditis following uremic hemopericardium. Am Heart J 1970; 79:390–393.

    Article  PubMed  Google Scholar 

  63. Sagristà-Sauleda J, Permanyer-Miralda G, Candell-Riera J, Angel J, Soler-Soler J. Transient cardiac constriction: An unrecognized pattern of evolution in acute idiophatic effusive pericarditis. Am J Cardiol 1987; 59:961–966.

    Article  PubMed  Google Scholar 

  64. Spodick DH. Arrhythmias during acute pericarditis. JAMA 1976; 235:39–46.

    Article  PubMed  CAS  Google Scholar 

  65. Peraino RA, Pericardial effusion in patients treated with maintenance dialysis. Am J Nephrol 1983; 3:319–322.

    Article  PubMed  CAS  Google Scholar 

  66. DePeace NL, Nestico PF, Schwartz AB, Mintz GS, Schwartz JS, Kotler MN, Swartz C. Predicting succes of intensive dialysis in the treatment of uremic pericarditis. Am J Med 1984; 76:38–46.

    Article  Google Scholar 

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© 1990 Kluwer Academic Publishers

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Morlans, M. (1990). Pericardial involvement in end stage renal disease. In: Soler-Soler, J., Permanyer-Miralda, G., Sagristà-Sauleda, J. (eds) Pericardial Disease. Developments in Cardiovascular Medicine, vol 108. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0481-1_8

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  • DOI: https://doi.org/10.1007/978-94-009-0481-1_8

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6702-7

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