Indomethacin Treatment of Pericarditis in Chronic Hemodialysis Patients

Symptomatic pericarditis occurs in the course of maintenance hemodialysis and often requires pericardiectomy in addition to other conventional measures. Three of 11 such patients were treated with frequent dialysis and general supportive treatment. Two of these required pericardiocentesis. The other eight received indomethacin; this was followed by prompt defervescence and abatement of pain within 6 to 24 hours. Only one patient required pericardiocentesis. On every occasion when treatment was discontinued during the first week, symptoms recurred. After three weeks to four months, the drug dosage could be tapered and discontinued. The pericardial aspirate was hemorrhagic in all three patients who required pericardiocentesis. Indomethacin appears to be effective in the treatment of the pericarditis associated with dialysis and precludes the need for invasive procedures.