No need for an “expiry date” in chronic peritoneal dialysis to prevent encapsulating peritoneal sclerosis

Abstract

Encapsulating peritoneal sclerosis (EPS) is drawing attention to the PD community because of its unpredictable onset and high mortality. Recently, the Scottish Renal Registry [1] has established the incidence of EPS and its correlation with PD duration in that region. The rate of EPS among patients on PD was 1.5%, with an incidence of 4.9 per 1,000 person-years. This rate is well within those reported previously (0.7–3.3%) [2–7]. Interestingly, the EPS rate increased with longer duration of PD up to 5 years (from 0% at\1 year to 8.8% at[5 to 6 years), and then decreased (5% at[6 years). The median duration of PD before EPS developed was 5.1 years. At the time of diagnosis only 26% of patients with EPS were on PD. In the remainder (74%), EPS was diagnosed after PD had been discontinued; 50% of them were diagnosed with EPS after kidney transplantation with calcineurin inhibitor-based immunosuppression.