Reversible Hyponatremia and Acute Renal Failure in Cardiac Tamponade

Ales Rozman, Vladimir Dimitric, Katja Adamic, Mateja Marc Malovrh and Julij Selb

Department of Endoscopy/Pulmonology, University Clinic of Respiratory and Allergic Diseases Golnik, Slovenia

^*Correspondance to: Ales Rozman 

 PDF  Full Text DOI: 10.25107/2474-1647.2101

Abstract

Background: Cardiac tamponade can be associated with hyponatremia and/or acute renal failure. Case reports and a few case series describe conditions separately. The objective of this study was to determine the frequencies of the reversible hyponatremia and acute renal failure in patients with cardiac tamponade after pericardial drainage and to determine whether there is any association between them.Methods: In this retrospective study medical records of patients treated by pericardial drainage between years 2010 and 2016 were reviewed. Cardiac tamponade was confirmed by cardiac chamber compression proved by echocardiography. Sample means/medians of paired data were compared with paired t-test (sodium concentration before and after drainage) and Wilcoxon signed-rank test (creatinine concentration before and after drainage).Results: Median amount of evacuated pericardial fluid was 1100 ml (rang 250 ml to 2000 ml) in 23 included patients. The mean pre-drainage sodium level was 133.1 mEq/l ± 8.5 mEq/l and the mean post-drainage sodium level was 139.0 mEq/l ± 4.2 mEq/l (p<0.002). Among 23 patients 10 (43.5%) had hyponatremia before drainage and 3 (13.0%) after drainage. The median pre-drainage serum creatinine concentration was 87.5 μmol/l (range =47 - 283 μmol/l) and median post-drainage serum creatinine concentration was 70 μmol/l (range =42 - 186 μmol/l) (p=0.014). Sodium and creatinine concentrations were correlated in a way, that sodium concentration increases, and creatinine concentration decreases after cardiac decompression (p<0.001).Conclusion: Hyponatremia and acute renal failure are associated with cardiac tamponade and recover spontaneously after pericardial drainage. Sodium concentration increase and creatinine concentration decrease after cardiac decompression are in a correlation

Keywords

Acute renal failure; Cardiac tamponade; Hyponatremia; Pericardial drainage; Pericardial effusion

Cite the article

Rozman A, Dimitric V, Adamic K, Marc Malovrh M, Selb J. Reversible Hyponatremia and Acute Renal Failure in Cardiac Tamponade. Clin Surg. 2018; 3: 2101.