In:
Clinical Cardiology, Wiley, Vol. 41, No. 5 ( 2018-05), p. 660-665
Abstract:
Pericardial effusion is common in hospitalized patients with chronic kidney disease (CKD). We sought to identify predictors and prognostic impact of pericardial effusion in CKD patients. Hypothesis Clinical and biochemical parameters can predict pericardial effusion in CKD patients. Methods In a retrospective nested case‐control design, we analyzed hospitalized adult patients with CKD stage 4, 5, or end‐stage renal disease diagnosed with pericardial effusion. Controls were same‐stage CKD patients without effusion. Results Among 84 cases and 61 controls, 44% and 34% were on dialysis, respectively. The mean creatinine was higher among cases versus controls (8.4±6.0 vs. 6.0±3.4 mg/dL, P = 0.002). Effusion was moderate to large in 46% of cases. Independent predictors of any pericardial effusion were serum potassium (OR: 1.95 per 1‐mEq/L increment, 95% CI: 1.21–3.13, P = 0.006), serum corrected calcium (OR: 1.33 per 1‐mg/dL decrement, 95% CI: 1.11–1.67, P = 0.015), and admission heart rate (OR: 1.29 per 10‐bpm increment, 95% CI: 1.03–1.62, P = 0.027). Corrected calcium level was an independent predictor of moderate to large pericardial effusion (OR: 1.38 per 1‐mg/dL decrement, 95% CI: 1.04–1.82, P = 0.023). Corrected calcium 〈 8.0 mg/dL demonstrated 95% specificity for moderate to large effusion. Patients with effusion had no significant difference in the composite endpoint of mortality or cardiovascular rehospitalization (P = 0.408). Conclusions In hospitalized CKD patients, hypocalcemia may be useful in identifying those with moderate to large pericardial effusion. In this population, pericardial effusion does not seem to be associated with adverse outcomes.
Type of Medium:
Online Resource
ISSN:
0160-9289
,
1932-8737
DOI:
10.1002/clc.2018.41.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2048223-1
Permalink
