title: Risk factors for developing encapsulating peritoneal sclerosis in the icodextrin era of peritoneal dialysis prescription.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS) is an uncommon but potentially devastating complication of peritoneal dialysis. We have observed an increased incidence in our centre over the last few years.
  
  
  METHODS
  To look at potential risk factors for developing EPS, we reviewed 39 cases diagnosed between 2000 and 2009 and compared these with a control group of 71 patients who had been treated by peritoneal dialysis for a minimum of 4 years. Both groups extensively used icodextrin, >80% of patients.
  
  
  RESULTS
  Both groups had been treated by peritoneal dialysis for a similar time: EPS median 54 months (46-87.5), compared to controls 70 (54-79.5). However, more of the EPS group were treated with peritoneal cyclers (75% vs 46%, X(2) = 6.86, P = 0.009) and prescribed more peritoneal dialysate 14.2 l/day +/- 0.7 vs 10.8 +/- 0.5, P < 0.0001. Although both groups were fast transporters, those with EPS had higher D/P creatinine ratios on peritoneal equilibration testing, 0.84 +/- 0.1 vs 0.77 +/- 0.1, P < 0.05, and lower peritoneal test ultrafiltration volumes, 193 +/- 26 ml vs 283 +/- 21 ml, P < 0.05. Discussion. The patients in the EPS group were faster transporters, with lower peritoneal equilibration and 24-h ultrafiltration volumes, and were exposed to greater volumes of peritoneal dialysates compared to peritoneal dialysis vintage controls.
authors.affiliation: University College London Center for Nephrology, Royal Free Hospital, Pond Street, London, UK.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Habib
authors.forename: Emma
authors.initials: E
authors.lastname: Preston
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005936:Glucans / Q000494:pharmacology*; D005947:Glucose / Q000494:pharmacology*; D015312:Hemodialysis Solutions / Q000494:pharmacology*; D006801:Humans; D000077607:Icodextrin; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000209:etiology*; D012307:Risk Factors
chemical_list: D005936:Glucans; D015312:Hemodialysis Solutions; D000077607:Icodextrin; D005947:Glucose