Uremic pericarditis treatment: Difference between revisions
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{{Uremic pericarditis}} | {{Uremic pericarditis}} | ||
{{Pericarditis}} | {{Pericarditis}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S. | {{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S. | ||
==Treatment== | ==Treatment== | ||
*Patient with uremic pericarditis should be treated with intensive [[hemodialysis]] which would most often results in resolution of [[pericardial effusion]] and [[chest pain]]<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }} </ref><ref name="pmid12923044">{{cite journal| author=Maisch B, Ristić AD| title=Practical aspects of the management of pericardial disease. | journal=Heart | year= 2003 | volume= 89 | issue= 9 | pages= 1096-103 | pmid=12923044 | doi= | pmc=PMC1767862 | url= }} </ref>within 1-2 weeks. [[Pericardiocentesis]] can be done to drain effusion if it is causing hemodynamic compromise such as in [[cardiac tamponade]]. Use of heparin free hemodialysis is adviced to prevent development of [[hemopericardium]]. | *Patient with uremic pericarditis should be treated with intensive [[hemodialysis]] which would most often results in resolution of [[pericardial effusion]] and [[chest pain]]<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }} </ref><ref name="pmid12923044">{{cite journal| author=Maisch B, Ristić AD| title=Practical aspects of the management of pericardial disease. | journal=Heart | year= 2003 | volume= 89 | issue= 9 | pages= 1096-103 | pmid=12923044 | doi= | pmc=PMC1767862 | url= }} </ref>within 1-2 weeks. [[Pericardiocentesis]] can be done to drain effusion if it is causing hemodynamic compromise such as in [[cardiac tamponade]]. Use of heparin free hemodialysis is adviced to prevent development of [[hemopericardium]]. | ||
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Latest revision as of 19:13, 6 February 2013
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Uremic pericarditis Microchapters |
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Pericarditis Microchapters |
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Uremic pericarditis treatment On the Web |
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Risk calculators and risk factors for Uremic pericarditis treatment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Treatment
- Patient with uremic pericarditis should be treated with intensive hemodialysis which would most often results in resolution of pericardial effusion and chest pain[1][2]within 1-2 weeks. Pericardiocentesis can be done to drain effusion if it is causing hemodynamic compromise such as in cardiac tamponade. Use of heparin free hemodialysis is adviced to prevent development of hemopericardium.
- Hypokalemia and hypophosphatemia should be prevented by supplementing the dialysis solution when appropriate[3].
- NSAIDs may be used in treatment of chest pain secondary to pericarditis. In case of recurrent pericardial effusion, pericardiotomy where a pericardial window for drainage of effusion may be made. In large refractory effusion, intra pericardial instillation of non-absorbable corticosteroids may be considered[4][5].
- Pericardiectomy should be done in refractory and severely symptomatic patients.
- Appropriate antivirals or antibiotics should be used in treatment of infective pericarditis which may occur in immunocompromised states resulting after renal transplantation[6].
References
- ↑ Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y; et al. (2004). "Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology". Eur Heart J. 25 (7): 587–610. doi:10.1016/j.ehj.2004.02.002. PMID 15120056.
- ↑ Maisch B, Ristić AD (2003). "Practical aspects of the management of pericardial disease". Heart. 89 (9): 1096–103. PMC 1767862. PMID 12923044.
- ↑ Emelife-Obi C, Chow MT, Qamar-Rohail H, Leehey DJ, Gandhi VC, Ing TS (1998). "Use of a phosphorus-enriched hemodialysate to prevent hypophosphatemia in a patient with renal failure-related pericarditis". Clin Nephrol. 50 (2): 131–3. PMID 9725787.
- ↑ Wood JE, Mahnensmith RL (2001). "Pericarditis associated with renal failure: evolution and management". Semin Dial. 14 (1): 61–6. PMID 11208042.
- ↑ Rutsky EA, Rostand SG (1987). "Treatment of uremic pericarditis and pericardial effusion". Am J Kidney Dis. 10 (1): 2–8. PMID 3605080.
- ↑ Sever MS, Steinmuller DR, Hayes JM, Streem SB, Novick AC (1991). "Pericarditis following renal transplantation". Transplantation. 51 (6): 1229–32. PMID 1646505.
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