Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Uremic pericarditis treatment
Introduction
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[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
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.
[[Category:Up-To-Date cardiology]
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.