—The purpose of our editorial was not to describe in detail our own experience with moderate to large pericardial effusion in patients treated with hemodialysis, but to draw attention to the potentially lethal nature of such effusions in this population and to point out the frequent ineffectiveness of intensified dialysis therapy.1-3 Since our editorial appeared, two additional articles supporting our point of view have been published. Peraino4 found that 14 of 17 patients with moderate to large effusions required surgical drainage. In ten of these 14 patients, surgical drainage had to be performed because conservative management had failed. Two patients died after requiring emergency pericardial drainage for acute tamponade. De Pace et al,5 in a statistical analysis of factors predicting success of treatment, found that only 8% of patients with large effusions responded to medical therapy. Although Dr Lazarus' published experience with patients with large effusions
Leehey DJ, Daugirdas JT, Ing TS. Pericardial Effusion-Reply. Arch Intern Med. 1984;144(6):1317. doi:10.1001/archinte.1984.00350180267049
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