Why does uremia cause fibrinous pericarditis?

Condition analysis:
Uremic pericarditis is thought to result from inflammation of the visceral and parietal layers of the pericardium by metabolic toxins that accumulate in the body owing to kidney failure. Other factors may be involved, however, because pericarditis also may occur in patients with chronic renal failure who already are receiving dialysis therapy.

Renal failure(uremia) accounts for approximately 12% of cases.

In the predialysis era, pericarditis developed in 35-50% of patients with uremia who had chronic renal failure and less commonly in those with acute renal failure. Death often followed in several weeks.

With dialysis, the incidence rate is less than 10%.

Pericarditis occurs after the onset of dialysis in 8-12% of cases.

ECG commonly does not show the typical ST-T segment changes due to lack of inflammation.

In uremic patients, heart rates may be deceptively slow with tamponade, fever, and hypotension due to autonomic impairment.

Some authors suggest that uremic pericarditis is a different entity from dialysis-associated pericarditis.

Asymptomatic pericardial effusions can occur in 36-62% of patients with uremia who require dialysis. They are often small to moderate in size, and they can occur secondary to volume overload. They can lead to significant hemodynamic complications during routine dialysis. The presence of a large pericardial effusion that persists for longer than 10 days after intensive dialysis has a high likelihood of causing tamponade.

Treatment is intensive dialysis.

If no improvement is noted after 7-10 days or if the patient has hemodynamic instability, proceed with pericardiocentesis or pericardiectomy.

Intensive dialysis is beneficial to most patients with uremia who develop pericarditis prior to dialysis. Dialysis-induced pericarditis fails to respond to more intensive dialysis in 25-33% of patients.

Instructions:
Uremia patients are suitable to eat saccharide including white sugar, rock candy, honey and fruit drops.

Uremia patients can eat plant oil like peanut oil, corn oil and sunflower seed oil.

Patients with uremia are allowed to eat low protein starch such as corn flour, cornstarch, lotus root starch and bean thread.

To increase the flavor of food, uremia patients can use condiment like white sugar, white vinegar, alcohol, pepper, caraway, lemon juice.