The epidemiology of encapsulating peritoneal sclerosis in an era of biocompatible neutral peritoneal dialysis...

Encapsulating peritoneal sclerosis (EPS) is one of the most serious complications of peritoneal dialysis (PD). Although the incidence and severity of EPS are said to have decreased with the widespread adoption of biocompatible neutral PD solutions, the overall prevalence in Japan remains unclear.

We extracted patients with EPS from 2012 to 2022 using the Web-based Analysis of Dialysis Data Archives (WADDA) system of the Japanese Society for Dialysis Therapy. EPS was defined as present in patients with a history of PD treatment presenting with symptoms of ileus due to intestinal adhesion. Patients with only ascites, calcification of the intestine or bloody PD effluent were not defined as having EPS. We collected data from patients with EPS including sex, age, dialysis modality, dialysis duration, cause of end-stage kidney disease and cause of death among deceased patients.

Approximately 700 patients with EPS were identified (60-65% males; mean age, 61-66 years), accounting for 5% of the sum of PD patients and patients on other dialysis modalities with experience of PD. The majority received hemodialysis or hemodiafiltration, with a mean dialysis duration of 12-14 years. The crude death rate was approximately 5% and death from ileus was more frequent than in the total cohort of dialysis patients.

The present study using a nationwide database of Japanese dialysis patients revealed a large number of patients with EPS. We plan to conduct a longitudinal study to clarify outcomes for patients with EPS.