Influência da dose de diálise sobre a frequência de pericardite assintomática em pacientes em terapia dialítica

Introducao: Ate o momento, estudos da frequencia da pericardite associada a dialise realizaram-se antes de 1997, ou seja, quando foi padronizado o clearance fracional de ureia (Kt/V) minimo de 1,2. Atualmente, caso a uremia seja fator etiologico para pericardite da dialise, espera-se reducao de sua prevalencia. Objetivo: Avaliar a prevalencia atual da pericardite da dialise e associar sua presenca com o Kt/V. Metodos: Avaliacao ecocardiografica da frequencia de efusao pericardica em 50 pacientes assintomaticos hemodilisados entre 2000 e 2004. A casuistica foi dividida em dois grupos segundo Kt/V inferior (G1:n=11) ou superior (G2:n=39) a 1,2. Resultados: Tres pacientes (6%) apresentaram efusao pericardica; frequencia inferior a da literatura (31,4%). A frequencia de pericardite em G1 foi superior a de G2 (p=0,0084). Conclusao: Tais achados corroboram a hipoeses da participacao da toxicidade uremica na g~enese da pericardite associada a dialise. Introduction: Until now, studies of the frequency of dialysis associated pericarditis were held before 1997, ie, when it was standardized fractional urea clearance (Kt / V) at least 1.2. Currently, if uremia is an etiological factor for dialysis pericarditis is expected to reduce its prevalence. Objective: To evaluate the current prevalence of dialysis pericarditis and associate its presence with the Kt / V. Methods: Echocardiographic evaluation of the frequency of pericardial effusion in 50 asymptomatic patients hemodilisados ​​between 2000 and 2004. The sample was divided into two groups according to Kt / V less (G1: n = 11) or later (G2: n = 39) to 1.2. Results: Three patients (6%) had pericardial effusion, often lower than in the literature (31.4%). The frequency of pericarditis in G1 was higher than G2 (p = 0.0084). Conclusion: These findings corroborate the participation of hipoeses uremic toxicity in ~ g enes of pericarditis associated with dialysis.

[1]  P. Barretti Indicações, escolha do método e preparo do paciente para a Terapia renal substitutiva (TRS), na Doença Renal Crônica (DRC) , 2004 .

[2]  J. Daugirdas Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. , 1993, Journal of the American Society of Nephrology : JASN.

[3]  S. Rostand,et al.  Treatment of uremic pericarditis and pericardial effusion. , 1987, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[4]  G. Mintz,et al.  Predicting success of intensive dialysis in the treatment of uremic pericarditis. , 1984, The American journal of medicine.

[5]  R. Gupta,et al.  Circulating immune complexes: possible toxins responsible for serositis (pericarditis, pleuritis, and peritonitis) in renal failure. , 1983, Nephron.

[6]  B. Maisch,et al.  Humoral immune reactions in uremic pericarditis. , 1983, American journal of nephrology.

[7]  C. Comty,et al.  Cardiac Complications of Regular Dialysis Therapy , 1983 .

[8]  Y. Asano,et al.  Uremic pericardial effusion: detection and evaluation of uremic pericardial effusion by echocardiography. , 1980, Clinical nephrology.

[9]  M. Lesch,et al.  Pericarditis in renal disease. , 1980, Progress in cardiovascular diseases.

[10]  M. Cochran,et al.  Fibrinous pericarditis and fibrinolysis in chronic dialysis patients. , 1979, Clinical nephrology.

[11]  D. Oreopoulos,et al.  Pericarditis in patients undergoing long-term hemodialysis and peritoneal dialysis. Incidence, complications and management. , 1977, The American journal of medicine.

[12]  W. Stone,et al.  Uremic pericarditis: a prospective echocardiographic and clinical study. , 1976, Clinical nephrology.

[13]  V. Parsons,et al.  EDITORIAL: The case for a specific uraemic myocardopathy. , 1975, Nephron.

[14]  C. Comty,et al.  Pericarditis in chronic uremia and its sequels. , 1971, Annals of internal medicine.

[15]  J. Merrill,et al.  Uremic Pericarditis: Clinical Features and Management , 1968, Circulation.

[16]  W. Kolff,et al.  Uremic pericarditis and cardiac tamponade in chronic renal failure. , 1966, Annals of internal medicine.