Echocardiographic Diagnosis, Classification, and Dialysis Treatment of Uremic Pericardial Effusion

Uremic pericardial effusion (UPE) was found by echocardiography in 61 (47%) out of 131 uremic patients. According to the echocardiographic findings, accompanying diseases and the response of UPE to the dialysis treatment, we tried to classify UPE into three main groups; uremia alone (40 patients-66%), uremia with infection (14 patients-23%), and uremia with other diseases (7 patients-11%). 1) UPE was recognized in 25 uremic patients (35%) among 65 subjects without dialysis treatment but having the serum creatinine levels higher than 5.0 mg/100 ml. The incidence of UPE was progressively increased with the elevation of serum creatinine levels (53% of patients with the serum creatinine levels higher than 10.0 mg/100 ml). 2) Uremia with infection group had some infectious signs; fever, leukocytosis, elevated erythrocyte sedimentation rate and sometimes pleuritis. 3) Uremia with other diseases group was those patients whose underlying diseases were other than chronic glomerulonephritis, such as hepatorenal syndrome, lupus nephritis, diabetic nephropathy and Alport's syn-drome. The echocardiographic detection of UPE proved to be convenient for early diagnosis of it and should be performed routinely in regularly dialysed patients.