The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Worsening Pericardial Effusion Despite 
Intensive Hemodialysis 

R. Royfman, M41*, A. Franz, M41, A. Grim, M31, M. Ali, MD1, M. Yassen, MD1, R.
Assaly, MD2, L. Dworkin, MD1

1Division of Nephrology, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Pulmonary and Critical Care Medicine, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: Rachel.royfman@utoledo.edu

Published: 05 May 2023 

End-stage renal disease affects over 500,000 people living in the United States. Complications of end-
stage renal disease can include pericarditis and pericardial effusion. Treatment for renal disease is 
dialysis, and the most common type of dialysis is hemodialysis. Some patients are able to successfully 
complete peritoneal dialysis at home, which is more convenient. However, patient compliance plays an 
important role in making sure peritoneal dialysis remains a successful treatment. Hemodialysis is 
associated with an increased risk of bleeding compared to peritoneal dialysis. In our case presentation, 
we discuss a 31 year old male developing a hemorrhagic pericardial effusion after undergoing an 
emergent transition from peritoneal dialysis to hemodialysis with heparin administration in the setting of 
worsening uremia during two separate hospital admissions less than one month apart. The patient had a 
pericardial effusion of 2.4 cm without tamponade physiology during his first admission, and upon the 
second admission the effusion grew to 5.75 cm with tamponade physiology. He had the fluid drained 
and showed significant clinical improvement. We will further discuss how urgent transition from 
peritoneal dialysis to hemodialysis with heparin use can worsen a hemorrhagic pericardial effusion. 

https://dx.doi.org/10.46570/utjms.vol11-2023-715 

https://dx.doi.org/10.46570/utjms.vol11-2023-715
mailto:Rachel.royfman@utoledo.edu