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Kidney Week

Abstract: FR-PO1061

Uremic Pericarditis in CKD: National Estimates of Hospitalizations, Procedures, and Outcomes (2006-2015)

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Walther, Carl P., Baylor College of Medicine, Houston, Texas, United States
  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
  • Niu, Jingbo, Baylor College of Medicine, Houston, Texas, United States
  • Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
Background

Uremic pericarditis and pericardial effusions are well-known and potentially deadly complications of chronic kidney disease (CKD). These complications can often be managed with intensive hemodialysis, but sometimes invasive procedures are indicated, for cardiac tamponade, diagnosis, or definitive management. We investigated national trends in uremic pericardial disease hospitalizations, procedures, and mortality.

Methods

We used the National Inpatient Sample, a 20% sample of US hospital discharges, from 2006-2015. We applied appropriate survey methods to obtain national estimates. We identified any CKD using ICD discharge codes, and pericarditis or pericardial effusion using the first 10 discharge codes. We excluded patients with possible non-uremic causes of pericardial disease (e.g., malignancy, myocardial infarction, myocarditis, non-pericardial cardiac surgery). We identified pericardiocentesis and pericardial window procedures using procedure codes.

Results

There were an estimated 24,508 (95%CI 23,647-25,369) hospitalizations for pericarditis in CKD that met the inclusion criteria. Age was 61±18 years. 43% of patients were female. An estimated 9.1% underwent pericardiocentesis alone, 8.8% underwent pericardiotomy alone, and 1.5% underwent both procedures. In-hospital mortality was 2.8% (2.5%, 6.4%, 2.7% and 2.8%, respectively, among those who underwent neither procedure, pericardiocentesis alone, pericardiotomy alone, and both procedures; p>0.05). Median (IQR) length of stay was 5 (3-8) days.

Conclusion

Uremic pericarditis and pericardial effusions remain an important complications of CKD, with approximately 1 in 5 hospitalizations involving an invasive pericardial intervention. In-hospital mortality is relatively low, but we were not able to assess post-hospital outcomes. Further investigations can target improved causal understanding and management.

Funding

  • Veterans Affairs Support