Long-term peritoneal dialysis and encapsulating peritoneal sclerosis in children

Area of Science:

• Nephrology
• Internal Medicine

Background:

• Encapsulating peritoneal sclerosis (EPS) is a critical complication of long-term peritoneal dialysis (PD), associated with over 30% mortality.
• The incidence of EPS is strongly correlated with the duration of PD treatment.

Purpose of the Study:

• To highlight the importance of surveillance for EPS risk factors in long-term PD patients.
• To identify key indicators that suggest considering PD termination to prevent EPS.

Main Methods:

• Review of existing reports on EPS incidence and duration of PD.
• Identification of clinical and biochemical markers associated with EPS development.

Main Results:

• Patients on PD for over 5 years, particularly those exceeding 8 years, require vigilant monitoring for EPS risk factors.
• Signs such as ultrafiltration failure, high dialysate/plasma creatinine ratio, peritoneal calcification, elevated C-reactive protein, and severe peritonitis warrant consideration for PD cessation.

Conclusions:

• Early and repeated surveillance for EPS risk factors is essential for patients undergoing long-term PD.
• Clinicians should consider terminating PD in patients with significant risk factors to prevent EPS development.
• The effect of modern biocompatible PD solutions on EPS incidence remains undetermined.