Aya Yamahatsu1, Chieko Hamada1, Kayo Kaneko1, Hiroaki Io1, Junichiro Nakata1, Yasuhiko Tomino2. 1. Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. 2. Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. yasu@juntendo.ac.jp.
Abstract
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is the most serious complication of peritoneal dialysis (PD) with a high mortality rate. The objective of the present study was to determine the clinical characteristics, the incidence rate, and the long-term outcome of EPS patients compared with control patients. METHODS: Two hundred and seventy patients with end-stage kidney disease were started on PD from 1987 to 2013 in the Juntendo University Hospital. EPS was diagnosed by clinical findings, radiological findings, and macroscopic inspection at the time of laparoscopy or surgical operation. Patient medical records were analyzed retrospectively, including clinical characteristics, laboratory findings, treatment modality, and outcomes. Using a Kaplan-Meier analysis, we compared the survival rate between EPS patients and control PD patients, matched for age, gender, diabetes, and duration of PD. RESULTS: Among 270 PD patients, 13 patients (4.8 %) developed EPS. The mean duration of PD was 120.5 ± 42.8 months. There were no significant difference in demographic findings between EPS and control PD patients. Among the EPS patients, seven patients died, of which four deaths were directly attributed to EPS. All four patients that had had surgical enterolysis were doing well and had no recurrences. No significant difference in the survival rate between EPS and control PD patients was observed in the Kaplan-Meier analysis. CONCLUSIONS: There was no significant difference in the survival rate between EPS patients and control PD patients. It appears that an early diagnosis by laparoscopy and accurate treatment, including surgical enterolysis, might improve mortality.
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is the most serious complication of peritoneal dialysis (PD) with a high mortality rate. The objective of the present study was to determine the clinical characteristics, the incidence rate, and the long-term outcome of EPSpatients compared with control patients. METHODS: Two hundred and seventy patients with end-stage kidney disease were started on PD from 1987 to 2013 in the Juntendo University Hospital. EPS was diagnosed by clinical findings, radiological findings, and macroscopic inspection at the time of laparoscopy or surgical operation. Patient medical records were analyzed retrospectively, including clinical characteristics, laboratory findings, treatment modality, and outcomes. Using a Kaplan-Meier analysis, we compared the survival rate between EPSpatients and control PDpatients, matched for age, gender, diabetes, and duration of PD. RESULTS: Among 270 PDpatients, 13 patients (4.8 %) developed EPS. The mean duration of PD was 120.5 ± 42.8 months. There were no significant difference in demographic findings between EPS and control PDpatients. Among the EPSpatients, seven patients died, of which four deaths were directly attributed to EPS. All four patients that had had surgical enterolysis were doing well and had no recurrences. No significant difference in the survival rate between EPS and control PDpatients was observed in the Kaplan-Meier analysis. CONCLUSIONS: There was no significant difference in the survival rate between EPSpatients and control PDpatients. It appears that an early diagnosis by laparoscopy and accurate treatment, including surgical enterolysis, might improve mortality.
Authors: Edwina A Brown; Wim Van Biesen; Fredric O Finkelstein; Helen Hurst; David W Johnson; Hideki Kawanishi; Roberto Pecoits-Filho; Graham Woodrow Journal: Perit Dial Int Date: 2009 Nov-Dec Impact factor: 1.756
Authors: David W Johnson; Yeoungjee Cho; Brian E R Livingston; Carmel M Hawley; Stephen P McDonald; Fiona G Brown; Johan B Rosman; Kym M Bannister; Kathryn J Wiggins Journal: Kidney Int Date: 2010-03-10 Impact factor: 10.612
Authors: Ruth M Tarzi; Adrian Lim; Steven Moser; Sohail Ahmad; Abraham George; Gowrie Balasubramaniam; Elaine J Clutterbuck; Wladyslaw Gedroyc; Edwina A Brown Journal: Clin J Am Soc Nephrol Date: 2008-07-30 Impact factor: 8.237