uremic pericarditis treatment

... Uremic pericarditis. Pericarditis :a complete guide Pratap Sagar Tiwari, MD, internal Medicine 2. Acute pericarditis is a clinical diagnosis.Symptoms include sharp, severe retrosternal chest pain worse with inspiration and a supine position.The classic physical finding is a pericardial friction rub. pericardium. Uremic pericarditis occurs as a result of inflammation of the pericardium due to toxins and immune complexes in patients with renal disease. A controlled study of the effect of indomethacin in uremic pericarditis. Tuberculous pericarditis can occur as part of an active tuberculosis infection. pain is also relieved by sitting up and leaning forward. The most important and initial management in patients not on dialysis is to begin dialysis as soon as... 4.2 Medications. The most effective treatment for uremic and dialysis pericarditis is to begin dialysis treatment if not already initiated, or to intensify treatment if the patient already is on dialysis. Treatment by catheter drainage and local nonabsorbable steroid administration'. Antibiotics should be started in the cases of infective myocarditis. Pericardial effusion with tamponade is a dreaded complication of pericarditis in patients with CRF, and its incidence seems to be higher with dialysis pericarditis than with uremic pericarditis. Uremic pericarditis: Due to fluid overload, electrolyte imbalance and uremic toxin accumulation, the pericardium (covering layer of the heart) of the heart gets inflamed. After reviewing the literature, it is concluded that the best early and late results in uremic pericarditis are obtained with pericardiectomy through an anterolateral thoractomy, the subxiphoid approach with creation of a pericardial window being a good alternative in critically ill patients. In the vast majority of these patients the pericarditis was present before dialysis and cleared clinically after beginning therapy. 1 Until recently the pericarditis was of minor importance, serving only as a warning that early death was a strong probability. 4. Medications to reduce the inflammation and swelling are often prescribed. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Treatment of uremic pericarditis. Acute pericarditis. The initial clinical manifestations of pericarditis and acute coronary syndrome may be similar, and initial EKG findings may overlap. Pericarditis. Pericarditis occurred 161 times in 136 of 1,058 patients undergoing chronic dialysis during a period of 13.7 years. Neoplasms. DISCUSSION: Uremic pericarditis was identified in setting of acute pericarditis in a patient with over-anticoagulation. The typical complaint of acute pericarditis is chest pain, which radiates to one or both trapezius muscle ridges. Uremic encephalopathy is defined as alterations in cognitive function in a patient with acute kidney injury or chronic kidney failure without other underlying conditions that would account for mental status change. This activity highlights the role of the interprofessional team in the care of patients with uremic pericarditis. Minuth AN. Uremic pericarditis is associated with azotemia, and occurs in about 6-10% of kidney failure patients. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 01 Jul 1987, 10(1): 2-8 DOI: 10.1016/s0272-6386(87)80003-3 PMID: 3605080 . Symptoms. The reported efficacy of intensive HD in the treatment of uremic pericarditis ranges from 76 to 100% and is more than 85% in most studies 6, 7,31,32. Dialysis (a procedure to clean the blood) is the most common treatment for uremia. Synonyms and Keywords: Pericarditis fibrinosa, Uraemic pericarditis, Pericarditis due to uremia, Pericarditis due to uraemia To go back to the main page on Pericarditis, click here. Recombinant human erythropoietin treatment improves platelet function in uremic patients. Treatment Uremic pericarditis is effectively treated with hemodialysis and can resolve the symptoms and decrease the size of any pericardial effusion, if present. Once you have finished reading the information in […] This activity highlights the role of the interprofessional team in the care of patients with uremic pericarditis. The doctor will examine you and ask questions about your symptoms and medical history. These patients are frequently treated with immunosuppressive therapy which may protect them in developing hyper-inflammatory response which is commonly seen in … And ineffective. The empiric nature of the management uremic pericarditis is reflected by the multiple ap­ proaches have been advocated for its treatment. Hemopericardium. Richard Bright first described the association of pericarditis with renal failure in his landmark observation of 100 cases of patients with ‘albuminous urine’, which appeared in the Guys Hospital Report of 18361. Uremia. Suggested treatment approach for complicated pericarditis 1,3,7. Uremia. The pathogenesis of uremic bleeding tendency is … 4) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE. Rutsky EA, Rostand SG. PERICARDITIS occurs commonly in the terminal stages of chronic renal failure. Rutsky EA, Rostand SG (1987) Treatment of uremic pericarditis and pericardial effusion. -Uremia: uremic sx of N/V, poor appetite, fatigue and confusion in pt with low GFR-Uremic pericarditis -CKD progression to GFR <10-Volume overload not responsive to diuretics-Refractory or severe hyperkalemia (acute or chronic)-Refractory or severe metabolic acidosis-Drug toxicity/overdose (acute): Ethylene glycol, methanol, aspirin, lithium 1.1. Acute pericarditis. Dialysis is the main treatment option for uremia. Aplastic Anemia is a rare hematological disorder caused by bone marrow failure leading to pancytopenia. Am J Hematol 1988; 28:63. The conventional approach to treatment has been intensive (daily) dialysis, using minimal or regional heparinization for 10 to 14 days. Treatment for acute pericarditis may include medication for pain and inflammation, such as ibuprofen and aspirin. If there is treatment failure with dialysis, it is recommended one perform pericardiocentesis in patients with uremic pericarditis with effusion within 7 to 14 days. Pericarditis is usually mild and goes away without treatment. Conclusion Intrapericardial treatment of autoreactive pericarditis with 300mg.m −2.24h −1 of triamcinolone prevented recurrence of symptoms and relapse of effusion as effectively as the 600mg.m −2.24h −1 regimen, but with significantly fewer side effects. Uremic Pericarditis: Uremia associated with Chronic Renal Failure can cause pericarditis through a poorly-understood mechanism Collagen Vascular Disease Pericarditis: Pericardial inflammation is associated with certain collagen vascular diseases such as SLE and Rheumatoid Arthritis Recurrent pericarditis is a chronic and debilitating condition, characterized by relapsing and remitting pericardial inflammation. In view of the patient's increasing cardiac tamponade and the desire for a histologic diagnosis, a pericardial window was performed through the subxiphoid approach under local anesthesia. Aspirin 800mg every 8 hours for 7 to 10 days, followed by tapering during a period of 3 to 4 weeks OR 1.2. 1 The etiology is unknown and may be multifactorial. Home; Books; Search; Support. The International Journal of Artificial Organs , 01 Jan 1981, 4(1): 1-4 PMID: 7216528 . Thrombosis following desmopressin for uremic bleeding. Uremic Pericarditis is a major complication of kidney disease and may occur in patients with acute or chronic renal failure, before dialysis or on dialysis treatment. The inflammation is characterized by lymphocytes and granulocytes infiltrating the pericardium. Krumlovsky FA. Trxt: Find any underlying cause (infection) Intensive dialysis **NSAIDS are contraindicated! Treatment for pericarditis. Pericardiocentesis may be necessary to distinguish uremic pericarditis from bacterial pericarditis. 4. Pericarditis is inflammation of the pericardium, often with fluid accumulation. The instillation of agitated saline can help assess for inadvertent chamber puncture during procedure. Commonly used NSAID regimens include ( table 2 ): Ibuprofen (600 to 800 mg three times per day) – Ibuprofen should be given three times daily ( table 2 ). Pericarditis occurring in uremia and myocardial infarction is usually an incidental finding in the course of a more important disease. Invasive intervention is indicated if cardiac tamponade or pretamponade develops, if a pericardial effusion increases progressively in size, or if a large effusion persists after ten to 14 days of intensive … Constrictive pericarditis (all level C evidence) [ 3] Pericardiectomy is the treatment mainstay of chronic permanent constriction (class I). Colchicine may be added to the above as it decreases the risk of further episodes of pericarditis. How-To Tutorials; Suggestions; Machine Translation Editions; Noahs Archive Project; About Us. The treatment for uremic pericarditis is the same treatment that is given in the case of pericarditis. However, improvement in symptoms, resolution of pericardial effusion, and resolution of pericardial friction rub are reported goals of … Pericardial Effusion Normal 15-50 ml of fluid ETIOLOGY 1. Dialysis is when … Uremic pericarditis is thought to result from inflammation of the visceral and parietal layers of the pericardium by metabolic toxins that accumulate in the body owing to kidney failure. Pericarditis usually begins suddenly but does not last long. (NSAIDs) with or without colchicine. The pathogenesis is poorly understood. This activity reviews uremic pericarditis, including the etiology, pathophysiology, evaluation, and treatment. sharp pleuritic chest pain that is worsened by inhalation. Three patients had one or more recurrences of pericarditis while under regular intermittent dialysis. The prognosis depends on many factors, such as the severity of the underlying condition; although in most cases with appropriate treatment, it is good … There are two kinds of dialysis. Background: Uremic pericarditis, common at one time among dialysis patients, has become a rare entity in recent years.Due to its low incidence, its recognition has gained importance among internists, cardiologists, and nephrologists. Pericarditis is inflammation of the pericardium, often with fluid accumulation. Uremia. Endocarditis, Pericarditis, and Rheumatic Carditis- Cardiovascular Nursing This post will be a review of all the information that nursing students need to know about endocarditis, pericarditis, and rheumatic carditis. 4.6'13 It is generally agreed that dialysis … Heart attack (myocardial infarction). Pericarditis. We recommend that patients with pericarditis and no hemodynamic alterations receive intensive hemodialysis, with careful hemodynamic and echocardiographic monitoring, as primary treatment. Many cases of pericarditis get resolved within 2 to 3 weeks. The treatment in viral or idiopathic pericarditis is with aspirin, or non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen). This is referred to as idiopathic pericarditis. The treatment includes medication for the underlying infection. The underlying cause has to be identified and properly treated. Dialysis is when … viral pericarditis is usually self-limited. Etiologies. To the Editor.— The results of the use of local steroid instillation in intractable uremic pericarditis in 45 patients described by Buselmeier et al (240:1358, 1978) were impressive. (NSAIDs) with or without colchicine. Neoplasms. Treatment for acute pericarditis can be outpatient, if the etiology is presumed to be viral or idiopathic and the patient is hemodynamically stable, ... Any patient with myocarditis, uremic pericarditis, enlarged pericardial silhouette on chest X-ray, or … Pericarditis, in most cases, is treated with analgesics and anti-inflammatory medications such as non-steroidal anti-inflammatory drugs (NSAIDs), commonly ibuprofen, aspirin or naproxen. At other occasions, other medications such as colchicines or steroids may also be needed to treat severe pain symptoms. Two patients developed pericardial effusion and one of them had ascites. Physical exam. Commonly used NSAIDs include Ibuprofen and Indomethacin. 2 Forms Of Pericarditis and Renal Failure. To determine the impact of indomethacin on the course of uremic pericarditis we performed a prospective, double blind study in which 24 patients with endstage chronic renal failure and pericarditis randomly received indomethacin, 25 mg four times daily, (11 patients) or a Pericardial Effusion Medicine & Life Sciences Pericarditis refers to any cause of pericardial inflammation, which may be local or systemic, and is the most common disorder involving the pericardium.40–42 The term pericarditis is a generalized term used for various forms of inflammation of the pericardium, with … To identify predictors of the success or failure of daily intensive dialysis in uremic pericarditis, a retrospective examination was made of initial clinical, laboratory, and echocardiographic data in 97 patients using univariate and multivariate statistical analysis. 1. Inflammation from infection, immunologic process. inflammation of the visceral and parietal membranes of the pericardial sac. Uremic pericarditis usually resolves with dialysis and rarely causes complications. Constrictive pericarditis (CP) is a chronic inflammatory process, often characterised by chronic scarring, fibrosis and calcification of the pericardium associated with diastolic dysfunction, eventually leading to low cardiac output and heart failure. Uremic pericarditis in children on chronic hemodialysis represents a difficult management problem, necessitating vigorous medical therapy and often surgical drainage of the pericardial effusion. Reviewed here is the latest on diagnosis, treatment and follow up of acute pericarditis. 1,2 However, prompt dialysis has dramatically decreased the It can be seen in predialysis patients and in dialysis patients who are on hemodialysis or peritoneal dialysis. Patients experience a sharp searing chest pain (pleuritic chest pain), along with shortness of breath. This activity reviews uremic pericarditis, including the etiology, pathophysiology, evaluation, and treatment. Its incidence was high in the past, was usually considered a terminal event, and was associated with a high mortality rate [ 1 ], but in more recent years it is rarely encountered. Symptoms include chest … Uremic frost: uremia leads to high levels of urea secreted in the sweat, the evaporation of which may result in tiny crystallized yellow-white urea deposits on the skin. Restrictions on exercise may. A pericardial effusion can be seen, with fibrinous strands traversing the pericardial space. Serositis. Six out of 21 patients attending maintenance hemodialysis had uremic pericarditis. 1) Uremic pericarditis: Uremic pericarditis has been diagnosed in 6 to 10 percent of patients with advanced renal failure (acute or chronic). Pericarditis disease is an inflammation of the pericardium. In this group, 67 patients showed response to intensive dialysis, and 30 patients did not (22 required surgery and eight died). For example, uremic pericarditis usually resolves with adequate renal dialysis. Uremia. Treatment for more-severe cases may include medications and, rarely, surgery. The causes of pericarditis are wide-ranging and include infection, autoimmune processes, malignancy, and uremia. "Myopericarditis" and "Perimyocarditis" Commonly the causes of pericarditis can contribute to direct myocardial injury resulting in damage and elevation of cardiac biomarkers (troponin and CK-MB). Treatment in patients with chronic kidney disease — Treatment for pericarditis in patients with advanced chronic kidney disease involves initiation or intensification of dialysis when uremia is the underlying cause, along with selective use of nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, and corticosteroids. However, a conservative path may be followed in the treatment of acute fibrinous pericarditis. Due to renal failure or dialysis Pericarditis can occur with acute renal failure or with chronic renal failure; Look for the effusion! Treatment. Patients on dialysis with suspected uremic pericarditis, may benefit form intensified dialysis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR. Recurrent pericarditis may occur in up to 30% of patients after an initial episode of acute pericarditis. Suggested treatment approach for complicated pericarditis 1,3,7. Ribot S, Frankel HJ, Gielchinsky I, Gilbert L. Clin Nephrol, 2(4):127-130, 01 Jan 1974 Cited by: 18 articles | PMID: 4847129. Treatment of uremic pericarditis. . Uremic pericarditis occurred in 41% of 83 patients admitted to the chronic dialysis program at the Peter Bent Brigham Hospital. A low-grade fever is often present.Diagnostic … Pericardium • The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity. Aspirin is the preferred agent for patients with pericarditis following myocardial infarction. Copyright © 2021, StatPearls Publishing LLC. The causes of pericarditis are wide-ranging and include infection, autoimmune processes, malignancy, and uremia. The risk of pericarditis is greater after a heart attack or after heart surgery (Dressler’s syndrome), radiation therapy or a percutaneous treatment… ... – Uremic pericarditis – Myxoedematous pericarditis – Chylopericardium 2. Aspirin (750-1000 mg every 8 hours for 1-2 weeks) or NSAIDs (ibuprofen 600 mg every 8 hours for 1-2 weeks) with gastric protection are recommended as first-line therapy for acute pericarditis. Bed rest is recommended, and the patient should be advised not to take part in any athletic activities at least for 6 months. By the time you have developed uremia, your kidneys are extremely damaged. Fingerprint Dive into the research topics of 'Uremic pericardial effusion. It requires specific antimicrobial treatment according to the causative etiologic agent, along with pericardial drainage. A second purpose is to describe the type of pain that occurs as a result of uremic pericarditis. For patients with idiopathic or viral pericarditis, The diagnosis of uremic pericarditis is made by electrocardiogram, which typically shows diffuse ST and T-wave elevations. An ECG showing pericarditis. However, the degree of pericarditis does not correlate with the degree of serum BUN or creatinine elevation. The primary treatment of acute pericarditis with colchicine may be based on results from the randomized, open-label COPE trial, in which colchicine (1-2 mg for day 1, then 0.5-1 mg/day for 3 months) was added to aspirin therapy and administered for 3 months. Management and Treatment How is uremia treated? We recommend that patients with pericarditis and no hemodynamic alterations receive intensive hemodialysis, with careful hemodynamic and echocardiographic monitoring, as primary treatment. Acute pericarditis is a type of pericarditis ( inflammation of the sac surrounding the heart, the pericardium) usually lasting less than 6 weeks. [] The term uremia, which literally means urine in the blood, was first used by Piorry to describe the clinical condition associated with renal failure. That this pericarditis can be painful is an accepted fact. 13 Oxidative stress also contributes to prevalent coronary artery disease, 14 uremic pericarditis and in severe cases cardiac tamponade. is most commonly caused by viral infection; however, a number of conditions can cause an inflammatory response in the. This activity highlights the role of the interprofessional team in the care of patients with uremic pericarditis. Primarily the Uremic Pericarditis is a major complication of kidney disease and may occur in patients with acute or chronic renal failure, before dialysis or on dialysis treatment. To determine the impact of indomethacin on the course of uremic pericarditis we performed a prospective, double blind study in which 24 patients with endstage chronic renal failure and pericarditis randomly received indomethacin, 25 mg four times daily, (11 patients) or a placebo (13 patients) for a 3-week period. It requires specific antimicrobial treatment according to the causative etiologic agent, along with pericardial drainage. Examples include: Pain relievers. pericarditis, aspirin, colchicine, corticosteroids, management, non-steroidal anti-inflammatory The treatment of acute pericarditis has been considerably improved by the … NSAIDS or Aspirin: first line treatment (in absence of contraindications) for viral or idiopathic pericarditis. Pericarditis may be caused by many disorders (eg, infection, myocardial infarction, trauma, tumors, metabolic disorders) but is often idiopathic. 4 TREATMENT 4.1 Dialysis. There is also a benign pericarditis of unknown etiology (idiopathic pericarditis). that may be acute or chronic. -Uremia: uremic sx of N/V, poor appetite, fatigue and confusion in pt with low GFR-Uremic pericarditis -CKD progression to GFR <10-Volume overload not responsive to diuretics-Refractory or severe hyperkalemia (acute or chronic)-Refractory or severe metabolic acidosis-Drug toxicity/overdose (acute): Ethylene glycol, methanol, aspirin, lithium • Recurrence occurs in up to 15% of cases. A controlled study of the effect of indomethacin in uremic pericarditis. Pericarditis is inflammation of the. This activity reviews uremic pericarditis, including the etiology, pathophysiology, evaluation, and treatment. CONCLUSIONS: Uremic pericarditis is now an uncommon cause of pericarditis, but it can be exacerbated in the setting of inflammatory pericarditis and over-anticoagulation, leading to rapid accumulation of bloody pericardial fluid and cardiac tamponade. title = "Intrapericardial triamcinolone hexacetonide in the treatment of intractable uremic pericarditis in a child", abstract = "Uremic pericarditis in children on chronic hemodialysis represents a difficult management problem, necessitating vigorous medical therapy and often surgical drainage of the pericardial effusion. Treatment of uremic pericarditis and pericardial effusion. Anemia, edema and uremic syndrome (pericarditis, encephalopathy, gastropathy, bleeding diathesis) were common presenting features for patients with the severe stage of the disease. Hemopericardium. Uremic pericarditis is treated with dialysis; pyogenic pericarditis requires antibiotic therapy and drainage. Uremic pericarditis can occur in people with uremia, an accumulation of urea and other waste products in the blood caused by kidney failure. Ibuprofen600mg every 8 hours for 7 to 10 days, followed by tapering during a period o… Following the resolution of symptoms, we taper the ibuprofen dose weekly for two to four weeks in an attempt to reduce the subsequent recurrence rate [ 8,18 ]. Radiation. Postcardiac surgery. Its incidence was high in the past, was usually considered a terminal event, and was associated with a high mortality rate [ 1 ], but in more recent years it is rarely encountered. Pericarditis 1. Pericarditis disease Causes of Pericarditis Disease: Pyogenic pericarditis is now a rare occurrence except in certain infectious states. Hemodialysis uses a machine to filter blood outside the body. Uremic pericarditis may occur in 35-50% of patients with advanced renal failure in the predialysis era and dialysis-associated pericarditis account to 8-12% of patients after the onset of dialysis. Uremic pericarditis: a complication of chronic kidney disease that causes fibrinous pericarditis. What Are Important Additional General Measures For Outpatients? Patients with pericarditis should also take care. Initiation of dialysis is the treatment of choice for uremic pericarditis, whereas intensification of hemodialysis is the mainstay of therapy for dialysis-associated pericarditis but is only effective approximately 50% of the time.256 Traditionally, heparin has been avoided during dialysis out of concern for hemorrhagic tamponade, although this has not been rigorously studied. In most patients, pericarditis is mild and resolves spontaneously, although treatment with a nonsteroidal anti-inflammatory drug or a short course of a corticosteroid may be helpful. Sometimes a major heart attack will inflame the pericardium next to the area of the heart that is damaged. To determine the impact of indomethacin on the course of uremic pericarditis we performed a prospective, double blind study in which 24 patients with endstage chronic renal failure and pericarditis randomly received indomethacin, 25 mg four times daily, (11 patients) or a Treatment . UREMIC PERICARDITIS Pericarditis is inflammation of the pericardium, the serous membrane enclosing the heart and the roots of the great blood vessels. pericardium. Introduction. Pericarditis may be caused by many disorders (eg, infection, myocardial infarction, trauma, tumors, metabolic disorders) but is often idiopathic. Contiguous inflammatory processes of the heart or lung (eg, myocardial infarction [MI], Dressler syndrome, idiopathic) Viral infections are the most common cause; acute pericarditis often follows upper respiratory tract … Postcardiac surgery. Purulent pericarditis is a rare but potentially life-threatening disease. Bleeding diatheses are characteristic findings in patients with end-stage renal disease (ESRD). Depending on the cause of your pericarditis, you may need an antibiotic or antifungal medication. Acute pericarditis treatment begins by addressing the underlying cause. Severe cases may require one or more of the following: pericardiocentesis to treat pericardial effusion/tamponade Purulent pericarditis is a rare but potentially life-threatening disease. Therapy typically starts with aspirin or nonsteroidal anti-inflammatory drugs. Pericarditis in patients with renal failure remains a serious problem, with mortality as high as 20%. There are no signs of cardiac tamponade. failure (uremic pericarditis), tumors, genetic diseases such as Familial Mediterranean Fever (FMF), or rarely, medications that suppress the immune system. Treatment for specific causes of pericarditis is directed according to the underlying cause. A kidney transplant may be indicated. Acute pericarditis (treatment). Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Uremic Pericarditis Treatment Acute inflammation typically manifests with … The patient's anemia was felt to be of microangiopathic hemolytic type consistent with a hemolytic uremic syndrome. Treatment for acute pericarditis can be outpatient, if the etiology is presumed to be viral or idiopathic and the patient is hemodynamically stable, ... Any patient with myocarditis, uremic pericarditis, enlarged pericardial silhouette on chest X-ray, … Adult Mild pericarditis may get better without treatment. Traumatic pericarditis — Due to an injury to the chest, impact, trauma or accident. • Intensive hemodialysis is far less effective in treating dialysis pericarditis than uremic pericarditis. Treatment of uremic pericarditis and pericardial effusion. A controlled study of the effect of indomethacin in uremic pericarditis. The management of this disease needs the combined efforts of internists, cardiologists, and nephrologists. NSAIDs, glucocorticoids (only use if refractory symptoms with NSAIDS and colchicine) Invasive treatments for pericarditis. Treatment Pain relief analgesics and anti-inflammatory ASA/NSAID’s Steroids for recurring pericarditis Antibiotics/drainage for purulent pericarditis Dialysis for uremic pericarditis Neoplastic: XRT, chemotherapy 12. Am J Kidney Dis 10(1):2–8. What is uremic pericarditis? Acute pericarditis is a common clinical entity diagnosed when two of the four findings are present: chest pain, pericardial friction rub, diffuse concave upward ST segment elevation on electrocardiogram (EKG), and pericardial effusion on echocardiogram .Recurrence after an acute episode occurs in at least 20-50% of the patients .With the advances in medicine, immunization, and treatment … It results from inflammation of the visceral and parietal membranes of the pericardial sac. Augmented hemodialysis was successful in treating uremic pericarditis even in patients with pericardial effusion.

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