title: Long-term peritoneal dialysis and encapsulating peritoneal sclerosis in children.
abstract: Encapsulating peritoneal sclerosis (EPS) is the most serious complication of long-term peritoneal dialysis (PD), with a mortality rate that exceeds 30%. There have been many reports of the incidence of EPS being strongly correlated to the duration of PD. Patients on PD for longer than 5 years, and especially those receiving this treatment for more than 8 years, should undergo careful and repeated surveillance for risk factors associated with the development of EPS. The development of ultrafiltration failure, a high dialysate/plasma creatinine ratio, as determined by the peritoneal equilibration test, peritoneal calcification, a persistently elevated C-reactive protein level, and severe peritonitis in patients on PD for longer than 8 years are signals that should prompt the clinician to consider terminating PD as a possible means of preventing the development of EPS. The impact of the newer, biocompatible PD solutions on the incidence of EPS has not yet been determined.
authors.affiliation: Department of Pediatric Nephrology, Tokyo Metropolitan Children's Hospital, Umezono 1–3–1, Kiyoseshi, Tokyo 204-8567, Japan. masahonda@amy.hi-ho.ne.jp
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology; D015996:Survival Rate; D028761:Withholding Treatment