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Nephrology (Carlton). 2017 Nov;22(11):907-912. doi: 10.1111/nep.12911.

Risk factors for encapsulating peritoneal sclerosis: Analysis of a 36-year experience in a University Hospital.

Author information

1
Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.

Abstract

AIM:

Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication that occurs in peritoneal dialysis (PD) therapy. The present study aimed to identify the risk factors, especially peritonitis and biocompatible PD fluid.

METHODS:

The study included 703 patients who received PD between January 1980 and March 2015 at two centres. The patients were divided into two groups: those who had developed EPS (EPS group: n = 44) and those who had no documentary evidence of EPS (non-EPS group: n = 659). The independent risks of EPS were determined by univariate and multivariate logistic models.

RESULTS:

Encapsulating peritoneal sclerosis occurred in 44/703 (6.3%) patients between January 1980 and March 2015. In multivariate logistic models of risk factors correlated with EPS, dialysate to plasma creatinine ratio (D/P Cr) by peritoneal equilibration test (PET) and history of peritonitis were risk factors for EPS development (P < 0.01, respectively) in addition to PD duration. Especially, total duration of peritonitis, defined by period between onset and resolution of peritonitis, was an important risk factor for EPS development in patients with a history of peritonitis. Receiver operating characteristic (ROC) curve analysis revealed that cut-off point for EPS development was 36 days. Moreover, biocompatible PD fluid contributed to decreased EPS development.

CONCLUSION:

Both the longer duration of peritonitis and higher D/P Cr, as well as the longer PD duration, were risk factors for EPS development. Furthermore, use of biocompatible PD fluid contributed to the decrease in EPS development.

KEYWORDS:

Biocompatible peritoneal dialysis fluid; dialysate to plasma creatinine (D/P Cr) ratio by peritoneal equilibration (PET); peritoneal dialysis; peritoneal dialysis duration; peritonitis

PMID:
27556577
DOI:
10.1111/nep.12911
[Indexed for MEDLINE]

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