title: Markers of uremia and pericardial effusion in peritoneal dialysis.
abstract: BACKGROUND
  Inadequate dialysis causes accumulation of toxic residues that may lead to the development of dialysis-associated pericardial effusion, but several other factors could be associated with this abnormality. The purpose of this study was to evaluate clinical risk factors to asymptomatic pericardial effusion in peritoneal dialysis.
  
  
  METHODS
  This cross-sectional study included 34 patients aged ≥ 18 years on peritoneal dialysis for at least 3 months, who showed no symptomatic pericardial effusion, hepatic cirrhosis, neoplasias, lupus or amputations, none in minoxidil use. Asymptomatic pericardial effusion was diagnosed by echocardiography. Risk factors were evaluated by logistic regression and Roc curve. Significance level was set at P < 0.05.
  
  
  RESULTS
  Patient age was 51 ± 15.9 years. Of the 34 patients enrolled, 16 were men and 11 diabetic. Five of them presented pericardial effusion. Logistic regression identifies low hemoglobin level (RR 0.454 CI 95%: 0.225-0.913; P = 0.027), low phase angle (RR 0.236 CI 95%: 0.057-0.984; P = 0.048) and low Kt/V (RR 0.001 CI 95%: 0.0-0.492; P = 0.03) as risk factors to pericardial effusion. Roc curve showed that hemoglobin levels below 12.2 g/dL, Kt/V lower than 1.9 and phase angle lower than 4.5° were the best cutoffs to predict pericardial effusion. Four patients showed these three parameters in the unfavorable range, and all these four patients presented pericardial effusion. The other patient with pericardial effusion had two of these parameters reduced.
  
  
  CONCLUSIONS
  These findings corroborate the hypothesis that uremia plays a significant role in the pathogenesis of dialysis-associated pericardial effusion.
authors.affiliation: Department of Internal Medicine, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, SP 18618-970, Brazil. alineantunes@fmb.unesp.br
authors.forename: Aline
authors.initials: A
authors.lastname: de Araujo Antunes
authors.forename: Jacqueline Costa Teixeira
authors.initials: JC
authors.lastname: Caramori
authors.forename: Francieli Delatim
authors.initials: FD
authors.lastname: Vannini
authors.forename: Silméia Garcia
authors.initials: SG
authors.lastname: Zanati
authors.forename: Pasqual
authors.initials: P
authors.lastname: Barretti
authors.forename: Beatriz Bojikian
authors.initials: BB
authors.lastname: Matsubara
authors.forename: Roberto Jorge
authors.initials: RJ
authors.lastname: da Silva Franco
authors.forename: Luis Cuadrado
authors.initials: LC
authors.lastname: Martin
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006454:Hemoglobins; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D014511:Uremia / Q000150:complications*
chemical_list: D015415:Biomarkers; D006454:Hemoglobins