Can surgery on the Digestive Organs correct Uremic Pericarditis?

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boblawrence | (Level 1) Associate Educator

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Uremia is an abnormal condition in which there is a build-up of products normally excreted by the kidney, such as urea and creatinine.  It is caused by kidney failure and is detected through blood tests as elevation of blood urea nitrogen (BUN) and serum creatinine.

Pericarditis is inflammation of the sac surrounding the heart.  The heart is covered by a thin visceral pericardium, and surrounded by a thin-walled sac called the parietal pericardium.  There is normally a small quantity of serous (watery) fluid over the heart in the pericardial sac.

Uremia can cause inflammation of the pericardium, resulting in pericardial effusion (abnormal build-up of pericardial fluid).  Also, as a result of the inflammation, fibrin, a sticky substance, is deposited on the pereicardial surfaces.  This may cause the two layers of pericardium to stick to one another.  The process might begin to heal, causing fibrous scar tissue to form.  At this point the pericardial sac is obliterated.  The scarred pericardium may restrict the ability of the heart to fill…so called restrictive pericarditis.  This can cause heart failure.

The mechanism of uremic pericarditis is unknown.

Patients with pericarditis may experience pleurisy (burning chest pain, sometimes aggravated by breathing), and the doctor might hear a friction rub with her stethoscope.  The friction rub is due to motion of the roughened, inflamed pericardial surfaces over one another during heartbeat.

Surgery on the digestive organs would have no beneficial effect on kidney function.  It is therefore not a treatment or solution for uremic pericarditis.  Uremic Pericarditis can be treated with anti-inflammatory medications and cortisone.  For restrictive pericarditis surgery may be needed.  It is also important to treat the underlying cause of the kidney failure.  If the kidneys have already been destroyed by disease, the patient may need dialysis (circulation of the patient’s blood through an artificial kidney), or kidney transplant.

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