Korean J Intern Med.  2013 Sep;28(5):587-593. 10.3904/kjim.2013.28.5.587.

Encapsulating peritoneal sclerosis: case series from a university center

• Hong KD
• Bae JH
• Jang YJ
• Jung HY
• Cho JH
• Choi JY
• Kim CD
• Kim YL
• Park SH

• KMID: 1780107
• DOI: http://doi.org/10.3904/kjim.2013.28.5.587

Abstract

BACKGROUND/AIMS
Encapsulating peritoneal sclerosis (EPS) is an often-fatal complication of long-term peritoneal dialysis (PD). We here report the clinical features of EPS in Korean PD patients from a single university center.
METHODS
The data were collected retrospectively from 606 PD patients at Kyungpook National University Hospital, between August 2001 and August 2011. The diagnosis of EPS was based on clinical signs and symptoms, and confirmed by radiological findings.
RESULTS
Eight patients (1.3%, four males) were diagnosed with EPS. The mean age of the patients was 48.5 years (range, 33 to 65). The mean duration of PD was 111.8 months (range, 23 to 186). All patients except for one had three or more episodes of peritonitis. Seven patients were diagnosed with EPS after stopping PD, and only one stayed on PD after initial diagnosis and treatment. Total parenteral nutrition and corticosteroids, in addition to tamoxifen therapy, were used to treat most of the patients, and one patient underwent surgery (adhesiolysis). The overall mortality rate was 50%.
CONCLUSIONS
EPS is a serious, life-threatening complication in patients on long-term PD. To reduce the incidence and mortality rate of EPS, careful monitoring and early diagnosis is needed.

Keyword

Peritoneal dialysis; Peritoneal fibrosis; Peritonitis

MeSH Terms

Adrenal Cortex Hormones/therapeutic use
Adult
Aged
Female
*Hospitals, University
Humans
Male
Middle Aged
Parenteral Nutrition, Total
Peritoneal Dialysis/*adverse effects/mortality
*Peritoneal Fibrosis/diagnosis/etiology/mortality/therapy
*Peritonitis/diagnosis/etiology/mortality/therapy
Republic of Korea
Retrospective Studies
Tamoxifen/therapeutic use
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Adrenal Cortex Hormones
Tamoxifen