title: Risk factors of severe peritoneal sclerosis in chronic peritoneal dialysis patients.
abstract: Peritoneal dialysis (PD) offers the healthiest way for starting renal replacement therapy (RRT) in End Stage Renal Disease patients, however exposes long-term PD patients to a dangerous complication named encapsulating peritoneal sclerosis (EPS). In this study, we searched for possible risk factors of EPS. Data were collected from two PD centers covering period 1995-2012 and comprised 464 patients. Control group defined as PD patients stayed on PD >42 month (n = 122), and case group was 12 confirmed EPS patients. Associations were analyzed using linear regression analysis. Prevalence and incidence of EPS were 2.59% and 8.9% with an incidence of 0.7% patient-years, respectively. The age at start of PD in EPS patients (32.75 ± 10.8 year) was significantly lower compared with control group (49.61 ± 16.18 year, p = .0001). The mean duration of PD in EPS and control group were 2494.4 ± 940.9 and 1890.2 ± 598.8 days (p = .002). Control group had 145 episodes of peritonitis during total duration of 7686 patient months (peritonitis rate of 1/53). This was 1/26 with a total 38 episodes of peritonitis during the total duration of 997 patient months (p = .01) for EPS group. In regression analysis, PD duration, age at PD start and duration of Ultrafiltration failure (UFF) were associated with EPS. Longer time being on PD, younger age, and higher UFF duration were the risk factors for EPS development.
authors: a Urology Department, Urology Research Center , Sina Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors: Sudabeh
authors: S
authors: Alatab
authors: b Department of Nephrology, Nephrology Research Center , Shariati Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors: Iraj
authors: I
authors: Najafi
authors: a Urology Department, Urology Research Center , Sina Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors: Gholamreza
authors: G
authors: Pourmand
authors: c Department of Epidemiology and Biostatistics, School of Public Health , Tehran University of Medical Sciences , Tehran , Iran.
authors: Mostafa
authors: M
authors: Hosseini
authors: d Department of Regenerative Biomedicine, Cell Sciences Research Center, Royan Institute For Stem Cell Biology and Technology , ACECR , Tehran , Iran.
authors: Soroosh
authors: S
authors: Shekarchian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000453:epidemiology* / Q000209:etiology; D010538:Peritonitis / Q000453:epidemiology* / Q000209:etiology; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D014462:Ultrafiltration / Q000009:adverse effects; D055815:Young Adult
keywords: End stage renal disease; chronic kidney disease; encapsulating peritoneal sclerosis; peritoneal dialysis; peritoneal fibrosis