[Uremic pericarditis. Preliminary evaluation of treatment with indomethacin (author's transl)]

Abstract

Numerous therapeutic schemes have been proposed for pericarditis, whether or not accompanied by pericardial effusion in patients with terminal chronic renal insufficiency of subjects on periodic hemodialysis. All of the authors agree that dialysis must be initiated, or at least must not be interrupted once it is begun. There is some disagreement over the system that should be used (peritoneal dialysis or hemodialysis). Anti-inflammatory drugs have been used in association, since the condition is an inflammatory disease. Five episodes of pericarditis with daily hemodialysis and local heparine were treated, plus five other cases with the addition of 3 mg indomethacin/kg/day for 8 days. No secondary effects of indomethacin were reported. A definite reduction in the duration of pain, fever, pericardial rub, and increase in the size of the cardiac shadow was seen in the episodes treated with the association of indomethacin. This furthermore involved the number of days the patient was subjected to hemodialysis. Partial pericardiectomy was practiced on two patients not treated with indomethacin. The later course of the patients treated with indomethacin was more favorable since pericardial effusion did not lead to significant hemodynamic symptoms. There were no recurrences or other complications.