The importance of echocardiographic evaluation of pericardial effusion associated with mitral valve pseudoprolapse in patients with chronic renal failure

Abstract

To evaluate the clinical course of pericarditis in patients with chronic kidney disease (CKD), we studied echocardiography in 64 CKD patients and subdivided them into four groups according to their CKD condition and presence of effusion: 14 (22%) patients with pericardial effusion that formed during conservative treatment of CKD patients, 12 (19%) patients who developed the effusion while on regular hemodialysis, 31 (48%) CKD patients without pericardial effusion, and seven (11%) CKD patients with minimal effusion. In addition, the patients were then re- subdivided according to the amount of pericardial effusion into those with small amount, up to 1 cm echo- free space (EFS) (17 (27%) patients); with medium size pericardial effusion (9 (14%) patients); with large amount of pericardial effusion, above 2 cm (four (6%) patients); and with thickened pericardium (4 (6%) patients), three (5%) of whom were without pericardial effusion and one (2%) was with minimal effusion. Nine (15%) patients revealed signs of mitral valve prolapse. The presence of EFS between the posterior epicardium and pericardium during the entire cardiac cycle was found in 31 (48%) patients. We conclude that the presence of a positive EFS without other clinical symptoms does not confirm with certainty the presence of pericarditis in CKD patients.