title: Lower mortality and inflammation from post-transplantation encapsulating peritoneal sclerosis compared to the classical form.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS) may occur after kidney transplantation (post-transplantation EPS) or may be diagnosed during or after peritoneal dialysis treatment (classical EPS). The aim of the present study was to investigate to what extent both EPS entities differ in clinical presentation, radiological findings, outcome, and the systemic inflammatory response, as measured by plasma C-reactive protein (CRP) levels both prior to and after EPS diagnosis.
  
  
  METHODS
  We performed a retrospective analysis of 15 post-transplantation EPS and 19 classical EPS patients who were diagnosed at seven hospitals in the Netherlands between January 1, 2000, and January 1, 2011.
  
  
  RESULTS
  There were no inter-group differences in age, duration of peritoneal dialysis, clinical presentation, or radiology findings at diagnosis. Post-transplantation patients had experienced a lower number of peritonitis episodes per patient-year (0.2 (0.0-0.4) vs. 0.7 (0.3-1.2), p = 0.01) with a longer interval between the last peritonitis and EPS diagnosis (18.1 (4.6-34.3) vs. 4.4 (0.89-13.78) months, p = 0.01). Post-transplantation EPS patients showed a remarkably lower mortality rate (40.0 vs. 84.2%, p < 0.05). In both groups a pattern of elevated CRP values was observed, increasing within the year before EPS diagnosis. In the post-transplantation group the median CRP level at diagnosis was lower (56.0 vs. 144.50 mg/l, p < 0.05) than in the classical EPS group.
  
  
  CONCLUSIONS
  Post-transplantation EPS has a similar clinical presentation as classical EPS but with a lower systemic inflammatory response and better outcome.
authors: Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Sayed M
authors: SM
authors: Habib
authors: Mario R
authors: MR
authors: Korte
authors: Michiel G H
authors: MG
authors: Betjes
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D065095:Calcineurin Inhibitors; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D010538:Peritonitis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D065095:Calcineurin Inhibitors; D002097:C-Reactive Protein