Uremia is an abnormal condition in which there is a
build-up of products normally excreted by the kidney, such as urea and creatinine. It
is caused by kidney failure and is detected through blood tests as elevation of blood
urea nitrogen (BUN) and serum creatinine.
Pericarditis is
inflammation of the sac surrounding the heart. The heart is covered by a thin visceral
pericardium, and surrounded by a thin-walled sac called the parietal pericardium. There
is normally a small quantity of serous (watery) fluid over the heart in the pericardial
sac.
Uremia can cause inflammation of the pericardium,
resulting in pericardial effusion (abnormal build-up of pericardial fluid). Also, as a
result of the inflammation, fibrin, a sticky substance, is deposited on the pereicardial
surfaces. This may cause the two layers of pericardium to stick to one another. The
process might begin to heal, causing fibrous scar tissue to form. At this point the
pericardial sac is obliterated. The scarred pericardium may restrict the ability of the
heart to fill…so called restrictive pericarditis. This can cause heart
failure.
The mechanism of uremic pericarditis is
unknown.
Patients with pericarditis may experience pleurisy
(burning chest pain, sometimes aggravated by breathing), and the doctor might hear a
friction rub with her stethoscope. The friction rub is due to motion of the roughened,
inflamed pericardial surfaces over one another during
heartbeat.
Surgery on the digestive organs would have no
beneficial effect on kidney function. It is therefore not a treatment or solution for
uremic pericarditis. Uremic Pericarditis can be treated with anti-inflammatory
medications and cortisone. For restrictive pericarditis surgery may be needed. It is
also important to treat the underlying cause of the kidney failure. If the kidneys have
already been destroyed by disease, the patient may need dialysis (circulation of the
patient’s blood through an artificial kidney), or kidney
transplant.
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