Pericardial Thickening is a Major Cardiac Complication in Patients with Chronic Kidney Disease at First Presentation

Background and Aims: A high prevalence of pericardial effusion and low prevalence of pericardial thickening have been documented in end stage renal disease (ESRD) especially in patients undergoing dialysis. The aim of the study was to investigate the presence of pericardial disease in predialysis chronic kidney disease (CKD) patients and to determine relationship of pericardial disease with the aetiology of CKD. Methods: This is a prospective cross-sectional conducted in Enugu, Nigeria. Eighty eight consecutive predialysis CKD patients, and forty four age and sex-matched control subjects were studied using twodimensional echocardiography. Results: Fifty six percent of the patients had pericardial disease while 44% did not. Pericardial disease was detected as early as stage 3 CKD. Of the 88 patients studied 15.9% had pericardial effusion only, 29.5% had pericardial thickening only and 10.2% had a combination of both. Majority (81.8%) were in ESRD. Systolic blood pressure, diastolic blood pressure, CKD stage, and serum phosphate correlated positively with pericardial disease. Haemoglobin concentration, glomerular filtration rate, and serum albumin correlated negatively with the presence of pericardial disease. The aetiology of CKD did not correlate with the presence of pericardial disease. Regression analysis showed that only serum haemoglobin predicted the presence of pericardial effusion. Conclusions: Pericardial disease is common in Nigerian patients with CKD at first evaluation and occurs as early as stage 3 CKD. Pericardial thickening is more prevalent than pericardial effusion. Pericardial effusion is predicted by low haemoglobin concentration. Echocardiography to detect pericardial disease should be part of routine investigation of patients with CKD.