Uremic pericarditis: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 5: Line 5:
==Overview==
==Overview==
[[Renal failure]] if not managed adequately can lead to [[pericardial effusion]] and [[pericarditis]], also known as uremic pericarditis. This is due to build up of metabolic toxins such as [[urea]], [[creatinine]], methylguanidine which cause inflammation of pericardium. With the introduction of [[dialysis]], the incidence of uremic pericarditis has been considerably lowered<ref name="pmid5673609">{{cite journal| author=Bailey GL, Hampers CL, Hager EB, Merrill JP| title=Uremic pericarditis. Clinical features and management. | journal=Circulation | year= 1968 | volume= 38 | issue= 3 | pages= 582-91 | pmid=5673609 | doi= | pmc= | url= }} </ref>.
[[Renal failure]] if not managed adequately can lead to [[pericardial effusion]] and [[pericarditis]], also known as uremic pericarditis. This is due to build up of metabolic toxins such as [[urea]], [[creatinine]], methylguanidine which cause inflammation of pericardium. With the introduction of [[dialysis]], the incidence of uremic pericarditis has been considerably lowered<ref name="pmid5673609">{{cite journal| author=Bailey GL, Hampers CL, Hager EB, Merrill JP| title=Uremic pericarditis. Clinical features and management. | journal=Circulation | year= 1968 | volume= 38 | issue= 3 | pages= 582-91 | pmid=5673609 | doi= | pmc= | url= }} </ref>.
Uremic pericaritis can be further divided as:
#Uremic pericarditis in patients not undergoing dialysis.
#Uremic pericarditis in patients on maintenance dialysis.
==Etiology==
#Absence of [[dialysis]] in renal failure
#Inadequate dialysis in renal failure
#Volume overload during dialysis
#Infections


==Pathophysiology==
==Pathophysiology==
The pathophysiology of uremic pericarditis is not fully understood. However, there is a correlation observed with levels of blood urea nitrogen and creatinine. In [[renal failure]], the absence or inadequate [[dialysis]] can lead to accumulation of these toxins in the body which may cause inflammation of pericardium.  
The pathophysiology of uremic pericarditis is not fully understood. However, there is a correlation observed with levels of [[blood urea nitrogen]](usually >60 mg/dL) and [[creatinine]]. In [[renal failure]], the absence or inadequate [[dialysis]] can lead to accumulation of these toxins in the body which may cause inflammation of [[pericardium]] and development of adhesions between the two pericardial layers.
 
Patients undergoing dialysis may also develop [[pericarditis]]. In a series, 13% of patients undergoing hemodialysis developed pericarditis<ref name="pmid3605080">{{cite journal| author=Rutsky EA, Rostand SG| title=Treatment of uremic pericarditis and pericardial effusion. | journal=Am J Kidney Dis | year= 1987 | volume= 10 | issue= 1 | pages= 2-8 | pmid=3605080 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3605080  }} </ref>
 
Uremic pericarditis can occur as serous or hemorrhagic effusion with considerable overlapping. Hemorrhagic effusions are more common secondary to uremia induced platelet dysfunction and the use of [[anticoagulation]] during [[hemodialysis]].


[[Dialysis]] associated pericarditis may also be secondary to volume overload and bacterial or viral infections<ref name="pmid11172559">{{cite journal| author=Gunukula SR, Spodick DH| title=Pericardial disease in renal patients. | journal=Semin Nephrol | year= 2001 | volume= 21 | issue= 1 | pages= 52-6 | pmid=11172559 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11172559  }} </ref>.


==References==
==References==
Line 17: Line 31:
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Diseases involving the fasciae]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Revision as of 16:48, 29 June 2011

Pericarditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

HIV
Post MI
Dressler's syndrome
Post-pericardiotomy
Radiation
Tuberculosis
Uremia
Malignancy

Differentiating Pericarditis from other Diseases

Epidemiology and Demographics

Screening

Natural History, Complications and Prognosis

Pericardial Effusion
Cardiac Tamponade
Constrictive Pericarditis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Pericardiocentesis
Pericardial Window
Pericardial Stripping

Treatment Related Videos

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Uremic pericarditis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Google Images

American Roentgen Ray Society Images of Uremic pericarditis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Uremic pericarditis

CDC on Uremic pericarditis

Uremic pericarditis in the news

Blogs on Uremic pericarditis

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Uremic pericarditis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.

Overview

Renal failure if not managed adequately can lead to pericardial effusion and pericarditis, also known as uremic pericarditis. This is due to build up of metabolic toxins such as urea, creatinine, methylguanidine which cause inflammation of pericardium. With the introduction of dialysis, the incidence of uremic pericarditis has been considerably lowered[1]. Uremic pericaritis can be further divided as:

  1. Uremic pericarditis in patients not undergoing dialysis.
  2. Uremic pericarditis in patients on maintenance dialysis.

Etiology

  1. Absence of dialysis in renal failure
  2. Inadequate dialysis in renal failure
  3. Volume overload during dialysis
  4. Infections

Pathophysiology

The pathophysiology of uremic pericarditis is not fully understood. However, there is a correlation observed with levels of blood urea nitrogen(usually >60 mg/dL) and creatinine. In renal failure, the absence or inadequate dialysis can lead to accumulation of these toxins in the body which may cause inflammation of pericardium and development of adhesions between the two pericardial layers.

Patients undergoing dialysis may also develop pericarditis. In a series, 13% of patients undergoing hemodialysis developed pericarditis[2]

Uremic pericarditis can occur as serous or hemorrhagic effusion with considerable overlapping. Hemorrhagic effusions are more common secondary to uremia induced platelet dysfunction and the use of anticoagulation during hemodialysis.

Dialysis associated pericarditis may also be secondary to volume overload and bacterial or viral infections[3].

References

  1. Bailey GL, Hampers CL, Hager EB, Merrill JP (1968). "Uremic pericarditis. Clinical features and management". Circulation. 38 (3): 582–91. PMID 5673609.
  2. Rutsky EA, Rostand SG (1987). "Treatment of uremic pericarditis and pericardial effusion". Am J Kidney Dis. 10 (1): 2–8. PMID 3605080.
  3. Gunukula SR, Spodick DH (2001). "Pericardial disease in renal patients". Semin Nephrol. 21 (1): 52–6. PMID 11172559.

Template:WH Template:WS