To the Editor.—
Eliasson and Murphy's article on uremic pericarditis (229:1634, 1974) is of interest, but overinterpretation of their data, based on only three cases, would be hazardous. One important factor, apparently overlooked by the authors, was that all three of their patients developed pericarditis at the beginning of dialysis therapy (case 1, 12 days after hospitalization for "uremia"; case 2, 20 days after; and case 3, two days after hemodialysis was initiated). It is our experience that uremic pericarditis, occurring before or shortly after dialysis is initiated, usually responds very well to any therapy, as long as aggressive dialysis is part of the regimen, and precipitating factors are corrected. The difficult therapeutic problems pertain to those patients who develop pericarditis with increasing effusion or tamponade after their conditions have been stabilized on an intermittent dialysis program. Uremic pericarditis in this setting is often associated with systemic infection or surgery.