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Related Experiment Videos

Sclerosing peritonitis: the experience in Australia

R J Rigby1, C M Hawley

  • 1Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|March 3, 1998
PubMed
Summary

Sclerosing peritonitis, a serious complication of peritoneal dialysis, increases with longer dialysis duration. This study analyzed 54 cases, revealing a significant time-dependent rise in incidence and a high mortality rate.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Sclerosing peritonitis (SP) is a rare but severe complication of peritoneal dialysis (PD).
  • It is characterized by small-bowel obstruction (SBO) due to peritoneal encapsulation, adhesions, or mural fibrosis, often linked to peritonitis.
  • The study aimed to investigate the incidence, clinical characteristics, and contributing factors of severe SP.

Purpose of the Study:

  • Determine the incidence of severe sclerosing peritonitis (SP) in patients undergoing peritoneal dialysis (PD).
  • Identify clinical features and potential etiological factors associated with SP.
  • Evaluate the impact of dialysis duration on the risk of developing SP.

Main Methods:

  • A survey of all Australian dialysis units was conducted to identify cases of SP up to 1994.

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  • Inclusion criteria required surgical or radiological evidence of SP or SBO with characteristic peritoneal changes, excluding other causes of SBO.
  • Fifty-four patients meeting the criteria were analyzed.

    • Main Results:

    • The incidence of SP increased significantly from 1.9 to 4.2 per 1000 PD periods between 1980-1989 and 1990-1994.
    • Prevalence rose with PD duration, reaching 19.4% for patients on dialysis for over 8 years.
    • SP was diagnosed in 87% of cases, SBO in 92%, and haemoperitoneum in 8%. The mortality rate was 56%.

    Conclusions:

    • Severe sclerosing peritonitis is a significant complication of peritoneal dialysis.
    • There is a clear time-dependent increase in the incidence of SP with continuous ambulatory peritoneal dialysis (CAPD).
    • Longer duration of PD is a critical risk factor for developing SP.