Encapsulating peritoneal sclerosis: a rare, serious but potentially curable complication of peritoneal dialysis-experience of a referral centre in Germany

Chronic peritoneal dialysis (PD) can be complicated by encapsulating peritoneal sclerosis (EPS), the most severe complication associated with long-term PD. In this study, we retrospectively analysed 49 EPS patients regarding clinical presentation, histopathological findings, treatment and long-term...

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Bibliographic Details
Published in:	Nephrology, dialysis, transplantation Vol. 28; no. 4; pp. 1021 - 1030
Main Authors:	Latus, Joerg, Ulmer, Christoph, Fritz, Peter, Rettenmaier, Bianka, Biegger, Dagmar, Lang, Thomas, Ott, German, Scharpf, Christoph, Kimmel, Martin, Steurer, Wolfgang, Alscher, M Dominik, Braun, Niko
Format:	Journal Article
Language:	English
Published:	England 01-04-2013
Subjects:	Female Follow-Up Studies Germany Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - mortality Male Middle Aged Peritoneal Dialysis - adverse effects Peritoneal Fibrosis - etiology Peritoneal Fibrosis - mortality Peritoneal Fibrosis - prevention & control Prognosis Referral and Consultation Retrospective Studies Survival Rate Germany
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Summary:	Chronic peritoneal dialysis (PD) can be complicated by encapsulating peritoneal sclerosis (EPS), the most severe complication associated with long-term PD. In this study, we retrospectively analysed 49 EPS patients regarding clinical presentation, histopathological findings, treatment and long-term clinical outcome at our referral centre. Patients were divided into two clinical categories: severe and mild/moderate. All patients in the severe group and most patients in the mild/moderate group had symptoms consistent with EPS. The most common computed tomographic findings were peritoneal thickening in both groups. Small bowel dilatation was frequently present in the severe group. The time of onset of symptoms consistent with EPS to the surgical procedure was median 5 months with an inter-quartile range of 2-12 months in the severe group. To date, 25 of 31 patients in the severe group (follow-up 45.6 ± 39.0 months after surgery) are alive. In the mild/moderate group, 8 of 11 patients are alive (follow-up 41.6 ± 21.6 months). The histological features were consistent with EPS in all biopsies. The outcome of patients even with severe EPS is not worse. It is a precondition that these patients are treated in specialized referral centres. The time of first clinical symptoms consistent with EPS to requirement of surgery is very short. Earlier diagnosis of the disease is mandatory, even in asymptomatic patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0931-0509 1460-2385
DOI:	10.1093/ndt/gfs159