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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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[Encapsulating peritoneal sclerosis].

Jean-Philippe Ryckelynck1, Clémence Béchade1, Nicolas Bouvier1

  • 1Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, 14033 Caen cedex, France.

Nephrologie & Therapeutique
|June 4, 2017
PubMed
Summary
This summary is machine-generated.

Encapsulating peritoneal sclerosis (EPS) is a serious complication of peritoneal dialysis. Early detection and prevention strategies, including specialized solutions and lavage, are crucial for managing this condition.

Keywords:
Dialyse péritonéaleDialyse péritonéale au long coursEncapsulating peritoneal sclerosisKidney transplantationLong-term peritoneal dialysisMembrane péritonéalePeritoneal dialysisPeritoneal membranePeritoneal transportPerte de l’ultrafiltrationPéritonite encapsulante et sclérosanteTransplantation rénaleTransport péritonéalUltrafiltration failure

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Pathology

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of long-term peritoneal dialysis (PD).
  • It presents as a clinical syndrome with gastrointestinal obstruction, inflammation, and characteristic morphological changes.
  • The incidence of EPS ranges from 0.5 to 2.5%, with risks escalating with PD duration.

Purpose of the Study:

  • To define encapsulating peritoneal sclerosis (EPS) and its associated risk factors.
  • To outline the pathological and functional abnormalities in EPS.
  • To discuss current and preventative management strategies for EPS.

Main Methods:

  • Review of clinical, radiological, and pathological findings in EPS.
  • Analysis of functional abnormalities of the peritoneal membrane, including ultrafiltration and solute transport.
  • Identification of biomarkers in peritoneal effluent, such as cancer antigen 125 and interleukin-6.

Main Results:

  • Morphological changes include mesothelial layer loss, fibrosis, sclerosis, and vasculopathy.
  • Functional abnormalities involve ultrafiltration failure, fast peritoneal membrane transport, and loss of sodium sieving.
  • Cancer antigen 125 and interleukin-6 are identified biomarkers in peritoneal effluent.

Conclusions:

  • EPS pathophysiology likely involves a multi-hit process with key roles for growth factors and cytokines.
  • Management strategies include corticosteroids, tamoxifen, parenteral nutrition, and surgery (enterolysis).
  • Prevention focuses on physiological PD solutions, icodextrin, and peritoneal lavage post-PD cessation.