A Rare Complication of End-stage Renal Disease: Constrictive Pericarditis

Abstract

End-stage renal disease (ESRD) is a devastating disease associated with cardiovascular morbidity. The prevalence of pericardial syndromes associated with ESRD is increasing because the survival of chronic renal failure (CRF) patients is prolonged. Pericardial involvement in ESRD is seen commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis (CCP). Here, we report on a 17-year-old male patient who started hemodialysis after kidney graft loss and did not comply with the treatment, and presented with recurrent chest pain, dyspnea, and hypotension. Sequential hemodialysis treatment was given to the patient, who had recurrent pericardial effusion. Despite frequent hemodialysis treatment, the patient’s response to treatment was not adequate. After diagnosis with CCP, total pericardiectomy was performed for definitive treatment. A literature review revealed end-stage kidney disease appears to be a relatively rare cause of CCP. Only a few other cases have been reported so far, mostly in adulthood. This case highlights that CRF patients presenting with symptoms of right heart failure should be investigated for constrictive pericarditis with clinical evaluations and examinations.

Keywords

• pericardiectomy
• renal replacement treatment
• renal graft
• cardiovascular