Predicting Need for Surgical Drainage of Pericardial Effusion in Patients with End-Stage Renal Disease

Leehey, David J.; Daugirdas, John T.; Popli, Subhash; Gandhi, Vasant C.; Pifarré, Roque; Ing, Todd S.

doi:10.1177/039139888901201004

Cited by 15 publications

(23 citation statements)

References 17 publications

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“…Leehey et al [7] demonstrated that it is almost always necessary to resort to surgical intervention in dialysis pericarditis associ ated with large pericardial effusion (>250 ml). Hence, pericardiocentesis or surgical intervention should be per formed in the face of peritoneal dialysate in the abdomen.…”

Section: Discussionmentioning

confidence: 99%

Peritoneopericardial Communication after Pericardiocentesis in a Patient on Continuous Ambulatory Peritoneal Dialysis with Dialysis Pericarditis

Hou

Tsai²,

Hsu³

1994

Nephron

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A male patient aged 41 years had dialysis pericarditis with massive pericardial effusion in his 6-year on continuous ambulatory peritoneal dialysis (CAPD). Intensive hemodialysis failed to resolve the pericardial effusion. Pericardiocentesis via a subxiphoid approach was performed with placement of a pigtail catheter for drainage. A communication between peritoneal and pericardial cavities occurred, resulting in the leakage of the peritoneal dialysate into pericardial sac which was confirmed by a ^99mTc radionuclide scan. The fistula healed after removal of the catheter and discontinuation of CAPD. We suggest that pericardiocentesis via a subxiphoid approach for pericardial effusion should be cautiously exercised in CAPD cases for fear of peritoneopericardial fistula.

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Section: Discussionmentioning

confidence: 99%

Peritoneopericardial Communication after Pericardiocentesis in a Patient on Continuous Ambulatory Peritoneal Dialysis with Dialysis Pericarditis

Hou

Tsai²,

Hsu³

1994

Nephron

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“…Cardiovascular disease included cerebrovascular disease, coronary arterial disease, congestive heart failure and peripheral vascular diseases [1] . Pericarditis was diagnosed clinically by the clinical symptoms/signs, electrocardiography changes and echocardiographic evidence of pericardial effusion [7][8][9][10][11][12][13] . Effusion magnitude was assessed either retrospectively, by the amount of fluid removed upon pericardiocentesis or surgery, or by echocardiography.…”

Section: Definitionsmentioning

confidence: 99%

“…Recommended therapies have included intensive hemodialysis or peritoneal dialysis, non-steroidal anti-inflammatories, glucocorticoids, pericardiocentesis, intra-pericardial installation of a long-acting non-absorbable glucocorticoid, pericardiostomy, pericardial window and pericardiectomy [6] . Intensive hemodialysis has been defined as daily hemodialysis for a period of 10-14 days [7][8][9][10][11][12][13] .…”

mentioning

confidence: 99%

“…In terms of hemodialysis, uremic pericarditis always responds favorably to intensive hemodialysis, and the reported resolution rates are high [7,8,13] . On the other hand, intensive hemodialysis is less effective in treating dialysis pericarditis, and the reported resolution rates are low [7][8][9][10][11][12][13] .…”

mentioning

confidence: 99%

“…On the other hand, intensive hemodialysis is less effective in treating dialysis pericarditis, and the reported resolution rates are low [7][8][9][10][11][12][13] . Previous reports have involved mixed dialysis populations (diabetic and non-diabetic), so it is unclear whether the dialysis pericarditis resolution rates following intensive hemodialysis would remain the same for diabetics and non-diabetics patients.…”

mentioning

confidence: 99%

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Course and Outcome of Dialysis Pericarditis in Diabetic Patients Treated with Maintenance Hemodialysis

Tseng

Lee

Yen

et al. 2009

Kidney Blood Press Res

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Introduction: This observational study investigated the course and outcome of dialysis pericarditis in diabetic dialysis patients, as previous reports found that in contrast to uremic pericarditis, which responds in most cases to intensive hemodialysis, dialysis pericarditis resolves with intensification of hemodialysis in fewer cases. Methods: From 2002 through 2006, 88 maintenance hemodialysis patients (47 diabetic and 41 non-diabetic) were referred for management of dialysis pericarditis. Results: Dialysis pericarditis in 85.1% of diabetic and 82.9% of non-diabetic patients improved following institution of intensive hemodialysis. For the few unresponsive and critical cases, 8.5% of diabetic and 7.3% of non-diabetic patients received pericardiocentesis, whereas 6.4% of diabetic and 9.8% of non-diabetic patients received surgical drainage. In terms of outcome, 85.1, 4.3 and 10.6% of diabetic patients were alive without recurrence, alive with recurrence and deceased, respectively. There was no significant difference with their non-diabetic counterparts, for which the percentages were 87.8, 4.9 and 7.3%, respectively (p > 0.05). Kaplan-Meier analysis did not find any significant difference in survival as well (p > 0.05). Conclusion: Whether used in diabetics or not, intensive hemodialysis remains the primary and most effective dialysis pericarditis treatment, whereas pericardiocentesis or surgical drainage should be reserved for the few unresponsive and critical cases.

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Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

Rehman

Kumar

et al. 2017

Clinical Cardiology

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A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis.Constrictive pericarditis is also well documented in this population, ultimately resulting in pericardiectomy for definitive treatment. The management of pericardial diseases in ESRD patients involves internists, cardiologists, and nephrologists. Current guidelines lack clarity with respect to the management of pericardial processes in the ESRD population. Our review aims to describe the etiology, classification, clinical manifestations, diagnostic imaging tools, and treatment options of pericardial diseases in this population.

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Predicting Need for Surgical Drainage of Pericardial Effusion in Patients with End-Stage Renal Disease

Cited by 15 publications

References 17 publications

Peritoneopericardial Communication after Pericardiocentesis in a Patient on Continuous Ambulatory Peritoneal Dialysis with Dialysis Pericarditis

Peritoneopericardial Communication after Pericardiocentesis in a Patient on Continuous Ambulatory Peritoneal Dialysis with Dialysis Pericarditis

Course and Outcome of Dialysis Pericarditis in Diabetic Patients Treated with Maintenance Hemodialysis

Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

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