title: Fifteen cases of encapsulating peritoneal sclerosis related to peritoneal dialysis: a single-center experience in Japan.
abstract: To evaluate the incidence and characteristics of encapsulating peritoneal sclerosis (EPS), we analyzed 111 patients who had been transferred to hemodialysis and had been periodically monitored using the peritoneal equilibration test. Encapsulating peritoneal sclerosis was diagnosed in 11 patients. All patients had high-transport peritoneum, and 10 patients had been treated with continuous ambulatory peritoneal dialysis (CAPD) for more than 72 months. Incidence of EPS increased according to prolongation of CAPD. To evaluate outcome, we analyzed 15 cases of EPS. All patients were treated with total parenteral nutrition (TPN). Five patients improved with TPN alone. However, the remaining 10 patients showed deterioration. Of those 10, 4 patients died. They had not been treated with corticosteroids (CSs). The remaining 6 patients were treated with CSs, but they did not improve. Those cases required surgical treatment. The postoperative course in 4 patients was satisfactory, but 2 patients died. In our center, the EPS survival rate was 60%. In patients treated with TPN alone, the remission rate was only 33.3%. Administration of CSs could not improve that rate. In 6 patients treated with surgery, the mortality rate was 33.3%. When EPS symptoms are not ameliorated by CS and TPN, surgical treatment should be considered. To prevent EPS, high-risk patients who have more than 72 months on CAPD and who have a high-transport peritoneum should discontinue CAPD.
authors.affiliation: Department of Nephrology and Hypertension, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Ryo
authors.initials: R
authors.lastname: yamamoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hajime
authors.initials: H
authors.lastname: Takahashi
authors.forename: Naohiko
authors.initials: N
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayakawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Masato
authors.initials: M
authors.lastname: Ikeda
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Yoshindo
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Hideharu
authors.initials: H
authors.lastname: Mukai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D001692:Biological Transport; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D010289:Parenteral Nutrition, Total; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010537:Peritoneum / Q000378:metabolism / Q000473:pathology*; D006435:Renal Dialysis; D012598:Sclerosis
chemical_list: D005938:Glucocorticoids