Uremic Pericarditis and Cardiac Tamponade in Chronic Renal Failure

Abstract

Uremic pericarditis has been known to be a rather frequent entity, and has long been regarded as a sign of impending death. With the more extensive use of hemodialysis and peritoneal dialysis, and with the advent of renal allograft, many patients with chronic renal failure can be rehabilitated and pericarditis frequently disappears. Cardiac tamponade, hitherto rare, is more often recognized and is compatible with prolonged survival if adequately treated. Twenty-seven cases of chronic renal failure with uremic pericarditis diagnosed during life are reported. A pericardial friction rub was present in 25 cases. All patients were treated by hemodlalysis. Seventeen patients survived from 4 to 28 months. Cardiac tamponade occurred in 15 patients. Pericardiocentesis is frequently needed and partial pericardiectomy indicated in 5 patients. Cardiac tamponade needs early recognition and urgent therapy. If adequately treated, cardiac tamponade has a relatively good prognosis. The use of regional heparinization is recommended when dialyzing patients with uremic pericarditis.