title: Sclerosing encapsulating peritonitis in pediatric peritoneal dialysis patients.
abstract: The aim of this study was to define the incidence and characteristics of sclerosing encapsulating peritonitis (SEP) in pediatric peritoneal dialysis (PD) patients in Japan. A questionnaire was sent to all dialysis units with at least two pediatric PD patients. Among 687 patients registered, 11 cases (1.6%) of SEP were diagnosed. The mean age of patients with SEP at the start of PD was 9.7+/-3.6 years and at SEP diagnosis, 19.1+/-3.8 years. All patients had undergone PD for more than 5 years, and the mean PD duration was 9.6+/-3.3 years. SEP was diagnosed in 6.6% and 12% of patients dialyzed for >5 years and >8 years, respectively. The incidence of peritonitis among patients with SEP was not different from that among the Japanese pediatric registry. All patients had virtually no residual urine volume and 9 had impaired peritoneal ultrafiltration. Peritoneal calcification was the most-frequent radiological finding. Peritoneal biopsy was performed in 7 patients and confirmed sclerotic peritonitis in all. Ten patients transferred to hemodialysis, and only 1 patient underwent surgery. Three patients died. We recommend that patients on PD for more than 5 years who have impaired peritoneal ultrafiltration or peritoneal calcification should be carefully managed as presumptive cases of SEP.
authors.affiliation: Department of Pediatrics, Nishi-Sapporo National Hospital, Hokkaido, Japan. shoshii@pa2.so-net.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Hoshii
authors.forename: M
authors.initials: M
authors.lastname: Honda
authors.forename: N
authors.initials: N
authors.lastname: Itami
authors.forename: S
authors.initials: S
authors.lastname: Oh
authors.forename: C
authors.initials: C
authors.lastname: Matsumura
authors.forename: S
authors.initials: S
authors.lastname: Moriya
authors.forename: M
authors.initials: M
authors.lastname: Mori
authors.forename: K
authors.initials: K
authors.lastname: Hatae
authors.forename: Y
authors.initials: Y
authors.lastname: Ito
authors.forename: S
authors.initials: S
authors.lastname: Karashima
mesh_terms: D000293:Adolescent; D000328:Adult; D002177:Candidiasis; D016983:Enterococcus; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D009026:Mortality; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010537:Peritoneum / Q000473:pathology; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000473:pathology*; D012598:Sclerosis; D013203:Staphylococcal Infections