title: Prognosis of patients on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years.
abstract: BACKGROUND
  Patients who have been on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years are known to have a risk of developing encapsulating peritoneal sclerosis (EPS). However, the prognosis of patients on CAPD for over 10 years remains unclear.
  
  
  METHODS
  To better understand the efficacy of a variety of treatments for EPS, we retrospectively reviewed 25 patients who started CAPD at Toranomon Hospital from 1981 to 1997 and continued it for longer than 10 years.
  
  
  RESULTS
  The CAPD catheter was removed without peritoneal lavage in the initial 3 patients and they developed massive ascites. They all died of infection without resolution of the ascites. Accordingly, in the remaining 13 patients who did not undergo kidney transplantation, peritoneal lavage therapy was performed for 12 months before removing the CAPD catheter. As a result, 4 patients did not develop EPS. However, 9 patients had EPS with ascites, among whom 4 died of EPS-related diseases and 5 are alive. Five patients underwent cadaveric donor kidney transplantation. At the time of surgery, the CAPD catheter was removed without peritoneal lavage; 1 patient suffered from massive ascites immediately, although this subsided within 3 months after kidney transplantation, and 4 patients remain free from EPS-related symptoms and are doing well.
  
  
  CONCLUSIONS
  Kidney transplantation may be an option for preventing EPS. This study showed that improvement of the uremic state as well as treatment with immunosuppressants including corticosteroids may contribute to preventing EPS.
authors: Nephrology Center, Toranomon Hospital Kajigaya, Japan.
authors: Takafumi
authors: T
authors: Toyohara
authors: Yoshifumi
authors: Y
authors: Ubara
authors: Yasushi
authors: Y
authors: Higa
authors: Tatsuya
authors: T
authors: Suwabe
authors: Junichi
authors: J
authors: Hoshino
authors: Keiichi
authors: K
authors: Sumida
authors: Rikako
authors: R
authors: Hiramatsu
authors: Motonori
authors: M
authors: Nagasawa
authors: Eiko
authors: E
authors: Hasegawa
authors: Masayuki
authors: M
authors: Yamanouchi
authors: Noriko
authors: N
authors: Hayami
authors: Yuji
authors: Y
authors: Marui
authors: Naoki
authors: N
authors: Sawa
authors: Michio
authors: M
authors: Nakamura
authors: Shinji
authors: S
authors: Tomikawa
authors: Kenmei
authors: K
authors: Takaichi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000401:mortality / Q000639:trends; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000401:mortality* / Q000639:trends; D056627:Peritoneal Fibrosis / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies