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Related Experiment Videos

Encapsulating peritoneal sclerosis in Japan: a prospective, controlled, multicenter study.

Hideki Kawanishi1, Yoshindo Kawaguchi, Hiroyoshi Fukui

  • 1Tsuchiya General Hospital, Hiroshima, Japan. hidekawa@enjoy.ne.jp

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|September 24, 2004
PubMed
Summary

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Encapsulating peritoneal sclerosis (EPS), a serious complication of peritoneal dialysis (PD), occurred in 2.5% of patients over 4 years. Most cases were diagnosed after PD discontinuation, highlighting the need for caution with long-term PD use.

Area of Science:

  • Nephrology
  • Gastroenterology
  • Surgical Complications

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication associated with peritoneal dialysis (PD).
  • Understanding the incidence, clinical presentation, and outcomes of EPS is crucial for managing PD patients.

Purpose of the Study:

  • To determine the incidence of EPS in patients undergoing PD in Japan.
  • To investigate the clinical features and mortality rates associated with EPS.
  • To evaluate the impact of PD duration on EPS incidence and outcomes.

Main Methods:

  • A prospective, multicenter study involving 1,958 patients from 57 facilities in Japan.
  • Patients were followed for 4 years (April 1999 - March 2003) to observe EPS development.

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  • Data collection included PD duration, diagnosis of EPS, treatment modalities, and patient outcomes.

    • Main Results:

    • The overall incidence of EPS was 2.5% (48 out of 1,958 patients).
    • EPS was diagnosed after PD discontinuation in 68.8% of affected patients.
    • Incidence and mortality rates of EPS increased significantly with longer PD duration, reaching 17.2% incidence and 100% mortality after 15 years.

    Conclusions:

    • The study established an EPS incidence of 2.5% over a 4-year period, with a significant proportion diagnosed post-PD cessation.
    • While PD appears safe for up to 8 years, extended use necessitates heightened vigilance due to increasing EPS risk.
    • Improved diagnostic and therapeutic strategies may allow continued PD with acceptable risk for shorter durations.