Pericardial Effusion and Dilated Cardiomyopathy in Acute Kidney Failure Patients: Role of Nephrologists’ Performed Echocardiography

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Austin J Nephrol Hypertens. 2014;1(2): 1008.

Pericardial Effusion and Dilated Cardiomyopathy in Acute Kidney Failure Patients: Role of Nephrologists’ Performed Echocardiography

Di Lullo L1*, Rivera R2 and Santoboni A1

1Department of Nephrology and Dialysis, L. Parodi Delfino Hospital, Italy

2Department of Nephrology, S. Gerardo Hospital, Italy

*Corresponding author: Di Lullo L, Department of Nephrology and Dialysis, “L. Parodi Delfino Hospital”, Colleferro (Roma), Italy

Received: June 30, 2014; Accepted: July 21, 2014; Published: July 23, 2014

Introduction

Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias and sudden cardiac death represent main causes of morbidity and mortality in patients with acute (AKF) and chronic kidney disease (CKD). Pathogenesis includes close linkage between heart and kidneys and involves traditional and non-traditional risk factors.

Patients with acute kidney failure often present to emergency units with dyspnoea and anuria. Echocardiography usually shows the presence of dilated cardiomyopathy with left atrium enlargement also accompanied by mild to severe pericardial effusion.

Here we present two imagine case reports concerning two patients referred to our nephrology unit for acute kidney failure with oligo – anuria, dyspnoea and massive low limbs edema.

Case Presentation N° 1

66 years old male referred to emergency unit for growing dyspnoea, affected by chronic kidney disease (eGFR EPI 15 ml/ min/1.73 m2) due to diabetic nephropathy. He was a hypertensive patient on calcium channel blockers therapy (manidipine 20 mg/die) with chronic heart failure followed by nephrology ambulatory unit.

When he was admitted to nephrology unit, an echocardiography was performed by certified nephrologists and massive pericardic effusion (Figure 1) with left atrium enlargement (Figure 2) and EF (ejection fraction) decline were reported. Serologic tests showed an increase in creatinine (9.2 mg/dl) and BUN levels (98 mg/dl) with normokaliemia (4.4 mEq/L) and preserved bicarbonate levels (21mEq/L).