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      Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

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          Abstract

          A rising prevalence of end‐stage renal disease (ESRD) has led to a rise in ESRD‐related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. 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. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis. Constrictive pericarditis is also well documented in this population, ultimately resulting in pericardiectomy for definitive treatment. The management of pericardial diseases in ESRD patients involves internists, cardiologists, and nephrologists. Current guidelines lack clarity with respect to the management of pericardial processes in the ESRD population. Our review aims to describe the etiology, classification, clinical manifestations, diagnostic imaging tools, and treatment options of pericardial diseases in this population.

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          Author and article information

          Contributors
          kleina@ccf.org
          Journal
          Clin Cardiol
          Clin Cardiol
          10.1002/(ISSN)1932-8737
          CLC
          Clinical Cardiology
          Wiley Periodicals, Inc. (New York )
          0160-9289
          1932-8737
          05 September 2017
          October 2017
          : 40
          : 10 ( doiID: 10.1002/clc.2017.40.issue-10 )
          : 839-846
          Affiliations
          [ 1 ] Department of Internal Medicine Cleveland Clinic Cleveland Ohio
          [ 2 ] Department of Cardiovascular Medicine, Center for Diagnosis and Treatment of Pericardial Diseases Heart and Vascular Institute, Cleveland Clinic Cleveland Ohio
          [ 3 ] Department of Nephrology and Urology Cleveland Clinic Cleveland Ohio
          Author notes
          [* ] Correspondence

          Allan L Klein, MD, Department of Cardiovascular Medicine, 9500 Euclid Avenue, Cleveland, OH 44195 Email: kleina@ 123456ccf.org

          Article
          PMC6490618 PMC6490618 6490618 CLC22770
          10.1002/clc.22770
          6490618
          28873222
          © 2017 Wiley Periodicals, Inc.
          Page count
          Figures: 3, Tables: 1, Pages: 8, Words: 4936
          Categories
          Review
          Reviews
          Custom metadata
          2.0
          clc22770
          October 2017
          Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.2.1 mode:remove_FC converted:30.04.2019

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