Uremic pericarditis: Difference between revisions
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==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== | ||
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[[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
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Uremic pericarditis On the Web |
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American Roentgen Ray Society Images of 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:
- 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
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
- ↑ Bailey GL, Hampers CL, Hager EB, Merrill JP (1968). "Uremic pericarditis. Clinical features and management". Circulation. 38 (3): 582–91. PMID 5673609.
- ↑ Rutsky EA, Rostand SG (1987). "Treatment of uremic pericarditis and pericardial effusion". Am J Kidney Dis. 10 (1): 2–8. PMID 3605080.
- ↑ Gunukula SR, Spodick DH (2001). "Pericardial disease in renal patients". Semin Nephrol. 21 (1): 52–6. PMID 11172559.