Risk factors for encapsulating peritoneal sclerosis in long-term peritoneal dialysis: a retrospective observational study.
Encapsulating peritoneal sclerosis (EPS) is a serious complication that occurs in patients with long-term peritoneal dialysis (PD). Investigation of risk factors that contribute to EPS in patients on long-term PD therapy is needed. In a retrospective, observational study, data were collected for 107 patients treated with PD therapy for more than 5 years. Fifty cases of EPS were compared with 57 cases of non-EPS. To evaluate the impact of PD-associated peritonitis in EPS, univariate and multivariate logistic regression models were applied. Episodes of peritonitis, number of peritonitis episodes and the duration of peritonitis were included as explanatory variables in addition to previously reported risk factors. D/P Cr and serum β2MG levels in the EPS and non-EPS groups were: 0.82 ± 0.10 and 0.67 ± 0.12 (P < 0.01), and 33.8 ± 8.54 and 29.2 ± 8.18 mg/L (P < 0.01), respectively. Episodes of peritonitis, number of peritonitis episodes and the duration of peritonitis was 68% and 42% (P < 0.01), 1.80 ± 2.19 and 0.75 ± 1.07 times (P < 0.01), and 18.1 ± 15.3 and 10.2 ± 4.90 days (P < 0.01), in the EPS and non-EPS groups, respectively. Furthermore, multivariate logistic regression models demonstrated that both D/P Cr and the duration of peritonitis were independently associated with EPS (P < 0.01 and P < 0.05, respectively). In patients on long-term PD therapy, D/P Cr and the duration of peritonitis are independently associated with EPS. Earlier treatment to promote an early recovery from PD-associated peritonitis could be critical in preventing EPS.
Department of Internal Medicine, Division of Kidney and Hypertension, The Jikei University School of Medicine, Tokyo, Japan.
Masatsugu
M
Nakao
Keitaro
K
Yokoyama
Izumi
I
Yamamoto
Nanae
N
Matsuo
Yudo
Y
Tanno
Ichiro
I
Ohkido
Hiroshi
H
Hayakawa
Masato
M
Ikeda
Hiroyasu
H
Yamamoto
Tatsuo
T
Hosoya
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood / Q000378:metabolism*; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D015314:Dialysis Solutions; D003404:Creatinine
Encapsulating peritoneal sclerosis; Peritoneal dialysis; Peritoneal dialysis-associated peritonitis; Peritoneal fibrosis; Risk factors