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Related Concept Videos

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Ascites01:19

Ascites

DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...

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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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Posttransplant encapsulating peritoneal sclerosis: a worrying new trend?

Marien W J A Fieren1, Michiel G H Betjes, Mario R Korte

  • 1Nephrology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands. m.fieren@erasmusmc.nl

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|November 7, 2007
PubMed
Summary

Encapsulating peritoneal sclerosis (EPS) is a serious complication for patients on peritoneal dialysis (PD). This study highlights potential new risk factors, including kidney transplantation and immunosuppressive therapy, for EPS development.

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Published on: July 19, 2018

Area of Science:

  • Nephrology
  • Gastroenterology
  • Transplantation Medicine

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication in patients undergoing peritoneal dialysis (PD).
  • A cluster of 13 EPS cases was observed in two Dutch university hospitals, predominantly diagnosed post-kidney transplantation.
  • The occurrence prompted an investigation into risk factors beyond established ones like PD duration.

Purpose of the Study:

  • To explore potential risk factors for Encapsulating peritoneal sclerosis (EPS) development and progression, particularly after kidney transplantation.
  • To investigate the role of transplantation-related management, including immunosuppressive drugs and corticosteroid reduction, in EPS.
  • To advocate for further multicenter research focusing on immunosuppression and PD fluid characteristics.

Main Methods:

  • Retrospective analysis of 13 Encapsulating peritoneal sclerosis (EPS) cases.
  • Review of patient data focusing on timing of EPS diagnosis relative to kidney transplantation and PD treatment.
  • Literature review on known and potential risk factors for EPS.

Main Results:

  • Most observed EPS cases were diagnosed following kidney transplantation, presenting with severe bowel obstruction.
  • Cessation of PD treatment itself may be a risk factor for EPS.
  • Immunosuppressive treatments, specifically calcineurin inhibitors, and reduced corticosteroid use post-transplantation are implicated.

Conclusions:

  • Kidney transplantation and associated immunosuppressive regimens may contribute to Encapsulating peritoneal sclerosis (EPS) risk.
  • Further multicenter studies are needed to elucidate the role of immunosuppression and PD fluid characteristics.
  • Consideration of transfer from PD to hemodialysis is recommended for transplant-eligible patients with ultrafiltration failure.