BACKGROUND: We previously validated a scoring system for abdominal/pelvic CT scans in patients with symptomatic encapsulating peritoneal sclerosis (EPS). CT scans of patients with symptomatic EPS were significantly different from control peritoneal dialysis (PD) or haemodialysis patient scans; scans performed before EPS was clinically evident were near normal in 9 of 13 patients. We have now investigated CT scanning as a screening modality in a larger group of patients on long-term PD. METHODS: Pre-diagnostic CT scans performed in 20 patients for routine screening or other indications at least 3 months before EPS developed, and later diagnostic scans when EPS was clinically evident, were scored by three radiologists. The control group included CT scans of 20 PD patients who had not developed EPS (median follow-up 2.25 years). Analysis was by non-parametric tests. CT scores ranged from 0 to 22; > 2.5 was considered abnormal. RESULTS: Clinical EPS only developed after transplantation or transfer to HD. Diagnostic scans scored significantly higher than pre-diagnostic or control scans (median scores 9, 2 and 1; P < 0.001), confirming previous work. The pre-EPS diagnosis of 12 asymptomatic patients had a median CT score = 1.75, similar to the control group. Eight patients had had a limited episode of abdominal symptoms (seven required hospitalization), but did not have the clinical picture of EPS; their median CT score was 4.5 (P = 0.0016 cf control group). The time from pre-diagnostic scan to clinical EPS (median 0.82 years) and duration of PD at time of pre-diagnostic scan (median 7.1 years) did not differ significantly between the symptomatic and asymptomatic groups. CONCLUSIONS: CT screening of asymptomatic PD patients is not indicated; EPS may occur within a year or less of a normal CT scan. Abdominal symptoms in long-term PD patients can be associated with CT scan abnormalities; these patients are at increased risk of EPS after stopping PD.
BACKGROUND: We previously validated a scoring system for abdominal/pelvic CT scans in patients with symptomatic encapsulating peritoneal sclerosis (EPS). CT scans of patients with symptomatic EPS were significantly different from control peritoneal dialysis (PD) or haemodialysis patient scans; scans performed before EPS was clinically evident were near normal in 9 of 13 patients. We have now investigated CT scanning as a screening modality in a larger group of patients on long-term PD. METHODS: Pre-diagnostic CT scans performed in 20 patients for routine screening or other indications at least 3 months before EPS developed, and later diagnostic scans when EPS was clinically evident, were scored by three radiologists. The control group included CT scans of 20 PDpatients who had not developed EPS (median follow-up 2.25 years). Analysis was by non-parametric tests. CT scores ranged from 0 to 22; > 2.5 was considered abnormal. RESULTS: Clinical EPS only developed after transplantation or transfer to HD. Diagnostic scans scored significantly higher than pre-diagnostic or control scans (median scores 9, 2 and 1; P < 0.001), confirming previous work. The pre-EPS diagnosis of 12 asymptomatic patients had a median CT score = 1.75, similar to the control group. Eight patients had had a limited episode of abdominal symptoms (seven required hospitalization), but did not have the clinical picture of EPS; their median CT score was 4.5 (P = 0.0016 cf control group). The time from pre-diagnostic scan to clinical EPS (median 0.82 years) and duration of PD at time of pre-diagnostic scan (median 7.1 years) did not differ significantly between the symptomatic and asymptomatic groups. CONCLUSIONS: CT screening of asymptomatic PDpatients is not indicated; EPS may occur within a year or less of a normal CT scan. Abdominal symptoms in long-term PDpatients can be associated with CT scan abnormalities; these patients are at increased risk of EPS after stopping PD.
Authors: Harald Seeger; Joerg Latus; Daniel Kitterer; M Dominik Alscher; Dagmar Biegger; Jin Chen; Ilka Edenhofer; Rudolf P Wüthrich; Stephan Segerer Journal: Clin Exp Nephrol Date: 2017-05-27 Impact factor: 2.801
Authors: Catriona Goodlad; Frederick W K Tam; Sohail Ahmad; Gurjeet Bhangal; Bernard V North; Edwina A Brown Journal: Perit Dial Int Date: 2014-03-01 Impact factor: 1.756
Authors: Niko Braun; Peter Fritz; Christoph Ulmer; Joerg Latus; Martin Kimmel; Dagmar Biegger; German Ott; Fabian Reimold; Klaus-Peter Thon; Juergen Dippon; Stephan Segerer; M Dominik Alscher Journal: PLoS One Date: 2012-11-07 Impact factor: 3.240
Authors: Daniel Kitterer; Stephan Segerer; Wolfgang Steurer; Juergen Dippon; Angela Geissler; Christoph Ulmer; Niko Braun; Mark Dominik Alscher; Joerg Latus Journal: Int J Nephrol Renovasc Dis Date: 2015-08-13
Authors: Zia Moinuddin; Angela Summers; David Van Dellen; Titus Augustine; Sarah E Herrick Journal: Front Physiol Date: 2015-01-05 Impact factor: 4.566