Abstract
Background Encapsulating peritoneal sclerosis (EPS) is a rare but serious clinical complication of long-term peritoneal dialysis (PD) patients with high mortality. The purpose of this study was to assess the clinical characteristics of patients with EPS and to search for possible factors useful for EPS prevention and early diagnosis. Method This retrospective study was performed in a single dialysis center in Taiwan between August 1990 and April 2014. Overall, a total of 565 patients were included and the medical records of those patients who had developed EPS (EPS group) and those who had not developed EPS (control group) were collected. We compared several factors between these two groups. Result In the univariate analysis, EPS was significantly associated with a change of transport state (Delta 2) (p = 0.007), duration of PD (p < 0.001), duration of peritonitis treatment (p = 0.001), number of peritonitis episodes (p = 0.002), and fungus related peritonitis (p = 0.031). After multivariate logistic model analysis, we found that only the duration of PD was independently significantly associated with EPS (p = 0.034). In addition, we used the ROC curve and found that a duration of peritoneal dialysis of about 8.4 years is the best cut-off point to predict EPS occurrence. Conclusion In this study, long-termed PD duration is the only strong independent risk factor for EPS development. Total peritonitis times, total peritonitis treatment duration, and marked increased peritoneal D/Pcr ratio were also significantly associated with the duration of PD.
Highlights
Encapsulating peritoneal sclerosis (EPS) is a rare but serious clinical complication of long-term peritoneal dialysis (PD) patients with high mortality
After multivariate logistic model analysis, we found that only the duration of PD was independently significantly associated with EPS (p = 0.034)
We found that the duration of PD, changes of transport state (Delta 2), number of peritonitis episodes, peritonitis treatment duration, and fungus related peritonitis were significantly associated with EPS
Summary
Encapsulating peritoneal sclerosis (EPS) is a rare but serious clinical complication of long-term peritoneal dialysis (PD) patients with high mortality. After multivariate logistic model analysis, we found that only the duration of PD was independently significantly associated with EPS (p = 0.034). Long-termed PD duration is the only strong independent risk factor for EPS development. The prevalence rate of CKD in the world is around 8–16% [1]. The reasons of high prevalence rate of CKD include the aging of general populations, rising prevalence of diabetes mellitus (DM) and hypertension, and reducing death of organs failure patients in stroke and myocardial infarction due to the development of treatments [2]. The prevalence rate of ESRD in Taiwan is high compared to the rest of the world. In addition to the huge cost of ESRD management, patients who suffer from ESRD experience a decreased quality of life [4, 5] and lifespan [6]
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