Abstract Body (Do not enter title and authors here): Introduction
Pericardial effusions are common among patients with renal disease, especially those with advanced chronic kidney disease (CKD). This population frequently experiences uremic pericarditis, dialysis-associated pericarditis, and pericardial effusion. The natural history of pericardial effusions in the context of renal disease is highly variable. Aggressive hemodialysis can lead to resolution in some cases, whereas others may require immediate drainage for optimal management. Despite these clinical observations, there is a paucity of comprehensive literature evaluating the outcomes of pericardiocentesis in patients with CKD.

Hypothesis
We hypothesize that pericardiocentesis in CKD patients associated with poor outcomes compared to patients without CKD.

Methods
A retrospective observational study was conducted utilizing a national patient sample database from 2016-2021. Patients who underwent pericardiocentesis were identified using ICD-10 PCS codes. The study compared various demographics and clinical characteristics between patients with or without CKD.

Results
A total of 126,834 adults who underwent pericardiocentesis were included, of which 34780(27.4%) patients had CKD, 10, 956 (8.66%) patients had ESRD and 7145 (5.6%) patients were dialysis dependent. Patients with CKD were relatively older and had higher prevalence of comorbidities as shown in the below table.

Complications such as cardiac arrest (6.6% vs. 4.35%, p<0.01), cardiogenic shock (13.8% vs. 9.21%, p<0.01), ventricular arrhythmia (7.95% vs. 6.37%, p<0.01), acute kidney injury (41.45% vs. 24.55%, p<0.01), and mortality (12.57% vs. 9.56%, p<0.01) were significantly higher in CKD patients. The length of stay (11.3 vs. 8.6 days, p<0.01) and total hospital charges ($189,799 vs. $153,831, p<0.01) were also greater for CKD patients.

Conclusions
Patients with CKD who underwent pericardiocentesis for pericardial effusion has significantly higher rates complications, and mortality, along with longer hospital stays and increased healthcare costs . Further research with evaluation of etiology of pericarditis, current medical management, and stratifying patients based on CKD severity and dialysis dependence is required to assess the better outcomes.