Course and outcome of dialysis pericarditis in diabetic patients treated with maintenance hemodialysis.
BACKGROUND
This observational study investigated the course and outcome of dialysis pericarditis in diabetic dialysis patients, as previous reports found that in contrast to uremic pericarditis, which responds in most cases to intensive hemodialysis, dialysis pericarditis resolves with intensification of hemodialysis in fewer cases.


METHODS
From 2002 through 2006, 88 maintenance hemodialysis patients (47 diabetic and 41 non-diabetic) were referred for management of dialysis pericarditis.


RESULTS
Dialysis pericarditis in 85.1% of diabetic and 82.9% of non-diabetic patients improved following institution of intensive hemodialysis. For the few unresponsive and critical cases, 8.5% of diabetic and 7.3% of non-diabetic patients received pericardiocentesis, whereas 6.4% of diabetic and 9.8% of non-diabetic patients received surgical drainage. In terms of outcome, 85.1, 4.3 and 10.6% of diabetic patients were alive without recurrence, alive with recurrence and deceased, respectively. There was no significant difference with their non-diabetic counterparts, for which the percentages were 87.8, 4.9 and 7.3%, respectively (p > 0.05). Kaplan-Meier analysis did not find any significant difference in survival as well (p > 0.05).


CONCLUSIONS
Whether used in diabetics or not, intensive hemodialysis remains the primary and most effective dialysis pericarditis treatment, whereas pericardiocentesis or surgical drainage should be reserved for the few unresponsive and critical cases.
Tseng
Jing-Ren
JR
Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Lee
Ming-Jse
MJ
Yen
Kung-Chi
KC
Weng
Cheng-Hao
CH
Liang
Chih-Chia
CC
Wang
I-Kuan
IK
Chang
Chiz-Tzung
CT
Lin-Tan
Dan-Tzu
DT
Lin
Ja-Liang
JL
Yen
Tzung-Hai
TH
D000368:Aged; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000209:etiology*; D012008:Recurrence; D006435:Renal Dialysis / Q000009:adverse effects*; D015996:Survival Rate; D016896:Treatment Outcome