Uremic pericardial effusion: detection and evaluation of uremic pericardial effusion by echocardiography.

Echocardiography (UCG) was performed prior to and during hemodialysis therapy to detect and evaluate volumetrically the grade of pericardial effusion in 150 patients with chronic renal failure. The actual incidence of uremic pericardial effusion during the observation period was 62% and was higher during the first 3 months of therapy than at later stages. Pericardial effusion was classified from grade 0 (no effusion) to grade 5 (massive effusion). We compared the grade of effusion with laboratory test results, blood pressure, cardiothoratic ratio, left atrial and ventricular dimensions, and thickness of the intraventricular septum and left ventricular posterior wall. Significant differences between the patients with and without effusion were detected in the degree of systolic hypertension, dilatation of the left atrial chamber, anemia and hypoproteinemia. There was no correlation between the grade of effusion and creatinine, uric acid and calcium levels and changes of body weight. Our results confirm that insufficient dialysis as indexed by the degree of hypoproteinemia, anemia, hypertension and central overhydration, may play a role in the etiology of uremic pericardial effusion.