Uremic pericarditis: Difference between revisions

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{{Short description|A type of pericarditis associated with kidney failure}}
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{{Use dmy dates|date=October 2023}}
{{Infobox medical condition
 
| name            = Uremic pericarditis
'''Uremic pericarditis''' is a form of [[pericarditis]] that occurs in patients with [[uremia]], a condition associated with advanced [[kidney failure]]. It is characterized by inflammation of the [[pericardium]], the fibrous sac surrounding the [[heart]].
| image          = [[File:Pericarditis_fibrinosa.jpg|250px]]
 
| caption        = Fibrinous pericarditis, a common feature in uremic pericarditis
==Pathophysiology==
| field          = [[Nephrology]]
Uremic pericarditis is primarily caused by the accumulation of uremic toxins in the blood due to impaired kidney function. These toxins can lead to inflammation of the pericardium. The condition is often seen in patients with [[chronic kidney disease]] (CKD) or those undergoing [[dialysis]].
| symptoms        = [[Chest pain]], [[fever]], [[pericardial friction rub]]
 
| complications  = [[Cardiac tamponade]], [[constrictive pericarditis]]
==Clinical features==
| onset          = Typically in patients with advanced [[chronic kidney disease]]
Patients with uremic pericarditis may present with [[chest pain]], which is typically sharp and pleuritic in nature. The pain may worsen with deep breathing or lying flat and improve when sitting up or leaning forward. Other symptoms can include [[fever]], [[dyspnea]] (shortness of breath), and a pericardial friction rub, which is a scratching or grating sound heard with a stethoscope.
| duration        = Variable, depending on treatment
 
| causes          = Accumulation of uremic toxins due to [[renal failure]]
==Diagnosis==
| risks          = [[End-stage renal disease]], inadequate [[dialysis]]
The diagnosis of uremic pericarditis is often clinical, supported by laboratory findings of elevated blood urea nitrogen (BUN) and creatinine levels, indicating renal failure. [[Electrocardiogram]] (ECG) changes may show diffuse ST-segment elevation, although these are not specific to uremic pericarditis. [[Echocardiography]] can be used to assess for the presence of a pericardial effusion.
| diagnosis      = [[Electrocardiogram]], [[echocardiogram]], [[pericardial fluid analysis]]
 
| differential    = [[Acute pericarditis]], [[myocardial infarction]], [[pleuritis]]
==Treatment==
| treatment      = [[Dialysis]], [[nonsteroidal anti-inflammatory drugs]], [[corticosteroids]]
The primary treatment for uremic pericarditis is the initiation or intensification of dialysis to remove uremic toxins. [[Nonsteroidal anti-inflammatory drugs]] (NSAIDs) and [[corticosteroids]] may be used to manage inflammation and pain, although their use must be carefully monitored in patients with renal impairment.
| prognosis      = Generally good with appropriate treatment
 
| frequency      = Decreased with the advent of regular dialysis
==Prognosis==
}}
With appropriate treatment, the prognosis for uremic pericarditis is generally good. However, if left untreated, it can lead to complications such as [[cardiac tamponade]], a life-threatening condition where fluid accumulation in the pericardial space compresses the heart.
{{Short description|A form of pericarditis associated with kidney failure}}
 
'''Uremic pericarditis''' is a type of [[pericarditis]] that occurs in patients with [[chronic kidney disease]] or [[acute kidney injury]]. It is characterized by inflammation of the [[pericardium]], the fibrous sac surrounding the [[heart]], due to the accumulation of uremic toxins in the blood.
==Related pages==
===Pathophysiology===
In uremic pericarditis, the buildup of [[uremic toxins]] in the blood due to impaired kidney function leads to inflammation of the pericardium. This inflammation can result in the accumulation of fluid in the pericardial space, known as a [[pericardial effusion]]. The effusion can be serous or fibrinous, with fibrinous pericarditis being more common in uremic pericarditis.
===Clinical Features===
Patients with uremic pericarditis may present with [[chest pain]], which is typically sharp and pleuritic, and may be relieved by sitting up and leaning forward. Other symptoms can include [[fever]], [[dyspnea]], and a pericardial friction rub heard on auscultation. In severe cases, cardiac tamponade may occur, leading to hemodynamic instability.
===Diagnosis===
The diagnosis of uremic pericarditis is primarily clinical, supported by laboratory findings of elevated blood urea nitrogen (BUN) and creatinine levels. [[Electrocardiogram|ECG]] changes may include diffuse [[ST segment elevation]] and PR segment depression. [[Echocardiography]] can be used to assess the presence and size of a pericardial effusion.
===Treatment===
The primary treatment for uremic pericarditis is the initiation or intensification of [[dialysis]] to remove uremic toxins. [[Nonsteroidal anti-inflammatory drugs]] (NSAIDs) and [[corticosteroids]] may be used to reduce inflammation and pain. In cases of large pericardial effusion or cardiac tamponade, pericardiocentesis or surgical drainage may be necessary.
==See also==
* [[Pericarditis]]
* [[Pericarditis]]
* [[Chronic kidney disease]]
* [[Chronic kidney disease]]
* [[Acute kidney injury]]
* [[Dialysis]]
* [[Dialysis]]
 
[[Category:Cardiology]]
==References==
[[Category:Nephrology]]
* Levy, M., & Lichtstein, D. M. (2005). Pericarditis in end-stage renal disease. ''Seminars in Dialysis'', 18(2), 137-144.
* Reddy, P. S., & Curtiss, E. I. (1983). Uremic pericarditis: A review. ''American Heart Journal'', 106(5), 1135-1140.
 
[[Category:Cardiovascular diseases]]
[[Category:Kidney diseases]]
 
[[File:Pericarditis_fibrinosa.jpg|thumb|right|Fibrinous pericarditis, which can be seen in uremic pericarditis.]]

Latest revision as of 19:36, 8 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
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Uremic pericarditis
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Chest pain, fever, pericardial friction rub
Complications Cardiac tamponade, constrictive pericarditis
Onset Typically in patients with advanced chronic kidney disease
Duration Variable, depending on treatment
Types N/A
Causes Accumulation of uremic toxins due to renal failure
Risks End-stage renal disease, inadequate dialysis
Diagnosis Electrocardiogram, echocardiogram, pericardial fluid analysis
Differential diagnosis Acute pericarditis, myocardial infarction, pleuritis
Prevention N/A
Treatment Dialysis, nonsteroidal anti-inflammatory drugs, corticosteroids
Medication N/A
Prognosis Generally good with appropriate treatment
Frequency Decreased with the advent of regular dialysis
Deaths N/A


A form of pericarditis associated with kidney failure


Uremic pericarditis is a type of pericarditis that occurs in patients with chronic kidney disease or acute kidney injury. It is characterized by inflammation of the pericardium, the fibrous sac surrounding the heart, due to the accumulation of uremic toxins in the blood.

Pathophysiology[edit]

In uremic pericarditis, the buildup of uremic toxins in the blood due to impaired kidney function leads to inflammation of the pericardium. This inflammation can result in the accumulation of fluid in the pericardial space, known as a pericardial effusion. The effusion can be serous or fibrinous, with fibrinous pericarditis being more common in uremic pericarditis.

Clinical Features[edit]

Patients with uremic pericarditis may present with chest pain, which is typically sharp and pleuritic, and may be relieved by sitting up and leaning forward. Other symptoms can include fever, dyspnea, and a pericardial friction rub heard on auscultation. In severe cases, cardiac tamponade may occur, leading to hemodynamic instability.

Diagnosis[edit]

The diagnosis of uremic pericarditis is primarily clinical, supported by laboratory findings of elevated blood urea nitrogen (BUN) and creatinine levels. ECG changes may include diffuse ST segment elevation and PR segment depression. Echocardiography can be used to assess the presence and size of a pericardial effusion.

Treatment[edit]

The primary treatment for uremic pericarditis is the initiation or intensification of dialysis to remove uremic toxins. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may be used to reduce inflammation and pain. In cases of large pericardial effusion or cardiac tamponade, pericardiocentesis or surgical drainage may be necessary.

See also[edit]