Uremic pericarditis 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].

[[Category:Up-To-Date cardiology]

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