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Encapsulating peritoneal sclerosis in children on chronic PD: a survey from the European Paediatric Dialysis Working

Rukshana Shroff1, Constantinos J Stefanidis, Varvara Askiti

  • 1Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. rukshana.shroff@gosh.nhs.uk

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 26, 2013
PubMed

Insights

Encapsulating peritoneal sclerosis (EPS) in children on peritoneal dialysis (PD) is as common as in adults, but less deadly. Longer dialysis, frequent peritonitis, and ultrafiltration failure signal potential EPS in pediatric PD patients.

Area of Science:

  • Pediatric Nephrology
  • Gastroenterology
  • Dialysis Complications

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD).
  • Limited data exists on pediatric EPS, necessitating further investigation into its prevalence and outcomes in children.
  • This study addresses the scarcity of information regarding EPS in pediatric PD patients.

Purpose of the Study:

  • To determine the prevalence of EPS in children undergoing PD.
  • To identify risk factors associated with EPS development in pediatric patients.
  • To describe the clinical outcomes and mortality associated with pediatric EPS.

Main Methods:

  • A 10-year survey of chronic PD patients from January 2001 to December 2010 across 14 European dialysis units.
  • Inclusion of pediatric patients on chronic PD.
  • Data collection on EPS diagnosis, patient demographics, dialysis vintage, peritonitis rates, and clinical outcomes.

Main Results:

  • The prevalence of EPS in European children on PD was 1.5% (8.7 per 1000 patient-years).
  • Patients with EPS had significantly longer PD vintage (median 5.9 years) and higher peritonitis rates compared to non-EPS patients.
  • Ultrafiltration failure and bowel obstruction were common presenting symptoms, with 3 deaths and 8 patients on hemodialysis at follow-up.

Conclusions:

  • The prevalence of pediatric EPS is comparable to adults, but mortality is significantly lower.
  • A high index of suspicion for EPS is crucial in children with prolonged dialysis, high peritonitis rates, and ultrafiltration failure.
  • Early diagnosis and management are vital for improving outcomes in pediatric EPS.
Abstract

Keywords:
UF failureencapsulating peritoneal sclerosis, paediatrics, peritoneal dialysisperitonitis

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