Risk factors associated with encapsulating peritoneal sclerosis in Dutch EPS study

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Research

Background:

• Encapsulating peritoneal sclerosis (EPS) is a severe complication of peritoneal dialysis (PD).
• Its multifactorial pathophysiology and potentially increasing incidence warrant further investigation.
• Understanding risk factors is crucial for patient management and prevention strategies.

Purpose of the Study:

• To evaluate the independent associations of key factors with EPS.
• Specifically investigating PD duration, patient age, dialysis fluid use, and kidney transplantation outcomes.

Main Methods:

• A multicenter case-control study was conducted in the Netherlands.
• Data from 63 EPS patients and 126 matched control patients were analyzed.
• Log linear regression models were employed to assess associations with EPS appearance.

Main Results:

• Patients with EPS were significantly younger at PD initiation and had longer cumulative PD duration.
• Increased time on icodextrin and a higher rate of kidney transplantation were observed in EPS patients.
• Multivariate analysis identified cumulative PD duration, age at PD start, transplantation, time since transplantation, calendar time, time on icodextrin, and ultrafiltration failure as independent risk factors for EPS.

Conclusions:

• Peritoneal dialysis duration and younger age at initiation are linked to increased EPS risk.
• Kidney transplantation, time since transplantation, and use of icodextrin are also associated with higher EPS incidence.
• Ultrafiltration failure emerges as another significant risk factor for developing encapsulating peritoneal sclerosis.