Clinical predictors and outcomes of patients with pericardial effusion in chronic kidney disease

Abstract

In hospitalized CKD patients, hypocalcemia may be useful in identifying those with moderate to large pericardial effusion. In this population, pericardial effusion does not seem to be associated with adverse outcomes.

Predisposing factors and uremic pericardial effusion among ESRD patients undergoing dialysis

“…The collection of uremic toxins is likely to be the known cause of pericarditis. Furthermore, chronic buildup of the volume and hypoalbuminemia can also lead to non-inflammatory type pericardial effusion [ 7 ]. Patients with chronic kidney disease are also presented with uremic risk factors of cardiovascular disease such as increased oxidative stress, homocysteine, and lipoproteins [ 13 ].…”

“…A study showed that among hemodialysis ESRD and chronic kidney disease patients, pericardial effusion is seen to be 14.3% [ 13 ]. However, a study by Ravi, Iskander [ 7 ] reported a relatively higher incidence of pericardial effusion among dialysis patients, 44%. In a recent retrospective study, Bentata, Hamdi [ 19 ] reported that the incidence of small, moderate and large pericardial effusion among ESRD patients were 31.2%, 37.6% and 31.2%, respectively, which was small 8(6.1%), moderate in 8(6.1%) and large in 1 (0.7%) case(s) in our study.…”

“…Serum BUN and creatinine were positively correlated to the incidence of pericardial effusion in our patients. A recent study by Ravi, Iskander [ 7 ] reported that serum BUN and creatinine are significantly greater among chronic kidney or ESRD patients presented with pericardial effusion than patients otherwise. Nonetheless, greater sample size can confirm our findings with well-adjusted variables.…”

“…Furthermore, pericardial effusion can also be seen without the sign of pericarditis among these patients. Metabolic alterations such as hypocalcemia, hyperparathyroidism, hypoproteinemia, and hyperuricemia are predicted to contribute to pericardial effusion [ 7 ]. Lately, it has been established that incidence of uremic pericarditis is lowered among chronic dialysis patients, 5–20%, owing to the advancements in the dialysis procedure [ 8 ].Accumulation of toxic metabolites, high albuminuria, lowered creatinine clearance and difficulty in the maintenance of normal blood pressure during dialysis are some of the common causes of pericarditis and pericardial effusion in these patients [ 5 ].…”

Analisis Asuhan Keperawatan pada Pasien dengan Gagal Ginjal Kronik di ICU RSUP Dr. Sardjito dengan Pendekatan NANDA NOC NIC: Studi Kasus

“…11,9 Alasan menegakkan diagnosis keperawatan kedua adalah pasien memiliki keluhan sesak napas saat beraktivitas. Berdasarkan patofisiologi, pasien GGK stadium akhir akan mengalami akumulasi toksin uremik yang tidak teridentifikasi karena gangguan metabolik meliputi uremia, hipokalsemia, hipoproteinemia, dan hiperurisemia, 14 serta adanya edema paru yang diakibatkan oleh tertimbunnya cairan serosa atau serosanguinosa secara berlebihan di dalam ruang interstisial dan alveoli paru 15 yang mengakibatkan sirkulasi oksigen ke seluruh jaringan tidak efektif, sehingga tubuh mengompensasi dengan napas pendek dan saat beraktivitas. 13 Penyebab lain intoleransi aktivitas pada pasien GGK yang sedang menjalani terapi hemodialisis adalah adanya reduksi kadar hemoglobin (Hb) dalam darah, sebagai akibat dari penurunan eritropoetin karena ginjal tidak mampu menyerap zat besi, sehingga mengganggu kemampuan pasien untuk beraktivitas sehari-hari.…”