Pericardial Effusion Complicating Acute Tubular Necrosis

Goodner and Brown's1report based on autopsy findings in 2 cases of cardiac tamponade in uremic pericarditis emphasized that uremic pericarditis should be considered in the differential diagnosis of cardiac tamponade. Eight months later Guild, Bray, and Merrill2reported the first 2 cases of uremic pericarditis in which the diagnosis of pericardial effusion was made before death, and removal of pericardial fluid resulted in striking objective and subjective improvement. Goodner and Brown commented that since uremic pericarditis is such a poor prognostic sign in chronic renal disease, pericardiocentesis would probably not yield more than transient prolongation of life. They suggested, however, that cardiac tamponade might occur in a potentially reversible form of renal failure and that here its recognition and treatment might be life-saving. This report describes the first 2 cases, 1 certain and 1 probable, of massive pericardial effusion complicating a potentially reversible form of renal failure,