**3.4 Pericarditis**

We come across pericarditis in hemodialysis patients in two ways. The first is in the form of a uremic pericarditis. This type of pericarditis can be seen before starting the dialysis or in the first 8 weeks of dialysis. It is usually associated with uremia. The other type of pericarditis is a dialysis-related pericarditis that can be seen any time after the patient starts the dialysis. Although its definite cause is not known, insufficient dialysis and excess volume are the most blamed factors in pathogenesis (Rostand&Rutsky,1990; Rutsky& Rostand, 1987). Prevalence of pericarditis in dialysis patients is reported to be between 2 and 21% (Lange& Hillis,2004; Banerjee& Davenport,2006).

They can be clinically present as complaints such as a nonspecific chest pain, muscle weakness and coughing, but they can also come in as a hypotension and heart failure. A reduction of heart sounds and pericardial rubbing, and in serious cases, hypotension can be observed depending on the intensity of effusion during a physical examination. Classical ECG changes may not appear in uremic pericarditis. A final diagnosis is made using an ECHO (Shastri &Sarnak,2010).
