Encapsulating peritoneal sclerosis: experience of a tertiary referral center.
Phelan, P J Walshe, J J Al-Aradi, A Garvey, J P Finnegan, K O'Kelly, P McWilliams, J Ti, J P Morrin, M M Morgan, N
Phelan, P J
Walshe, J J
Al-Aradi, A
Garvey, J P
Finnegan, K
O'Kelly, P
McWilliams, J
Ti, J P
Morrin, M M
Morgan, N
Advisors
Editors
Other Contributors
Date
2010-05
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adult
Female
Humans
Ireland
Kidney Failure, Chronic
Logistic Models
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Peritoneal Fibrosis
Prevalence
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Female
Humans
Ireland
Kidney Failure, Chronic
Logistic Models
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Peritoneal Fibrosis
Prevalence
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.
We retrospectively reviewed the records of all our PD patients from 1 January 1989 until 31 December 2008. All suspected cases were confirmed at laparotomy. Multifactorial models adjusted for potentially confounding variables such as age and sex.
Eleven cases of EPS were identified giving a prevalence rate of 1.98%. Median duration on PD was substantially longer in affected versus unaffected patients (42.5 months versus 13.8 months; p = 0.0002). EPS patients had experienced a mean of 3.54 previous cases of peritonitis (1 infection per year versus 0.71 per year in unaffected patients; p = 0.075). Six patients died (54.5%) due to intra-abdominal sepsis including all five who presented with small bowel obstruction. Three patients had an omentectomy and adhesiolysis performed with a successful outcome.
Our study reinforces the link between duration on PD and EPS. While mortality was high in our cohort, emerging surgical techniques demonstrate a favorable outcome that can be achieved even in severely affected cases.
We retrospectively reviewed the records of all our PD patients from 1 January 1989 until 31 December 2008. All suspected cases were confirmed at laparotomy. Multifactorial models adjusted for potentially confounding variables such as age and sex.
Eleven cases of EPS were identified giving a prevalence rate of 1.98%. Median duration on PD was substantially longer in affected versus unaffected patients (42.5 months versus 13.8 months; p = 0.0002). EPS patients had experienced a mean of 3.54 previous cases of peritonitis (1 infection per year versus 0.71 per year in unaffected patients; p = 0.075). Six patients died (54.5%) due to intra-abdominal sepsis including all five who presented with small bowel obstruction. Three patients had an omentectomy and adhesiolysis performed with a successful outcome.
Our study reinforces the link between duration on PD and EPS. While mortality was high in our cohort, emerging surgical techniques demonstrate a favorable outcome that can be achieved even in severely affected cases.
Language
en
ISSN
1525-6049
eISSN
ISBN
DOI
10.3109/08860221003658274
PMID
20446784