Posttransplant encapsulating peritoneal sclerosis: a worrying new trend?

Marien W J A Fieren*, Michiel G H Betjes, Mario R Korte, Walther H Boer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

95 Citations (Scopus)

Abstract

Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication in patients on peritoneal dialysis (PD). We describe a cluster of 13 EPS cases occurring in 2 university hospitals in The Netherlands. Most of these cases were diagnosed after recent kidney transplantation, when the patients developed severe symptoms of bowel obstruction. This accumulation raised the question as to whether other than known risk factors, such as duration of PD treatment, could be involved in the development or course of EPS after transplantation. According to various publications, EPS has been diagnosed often after withdrawal from PD, suggesting that cessation in itself may be a risk factor. In addition, transplantation-related management should be considered to play a role, including the use of the profibrotic calcineurin inhibitors and the trend to reduce the load of corticosteroids in treatment regimes. To identify risk factors, further multicenter studies are required, paying special attention to alterations in immunosuppressive treatment regimens as well as PD prescriptions, including PD fluid characteristics. Transfer from PD to hemodialysis should be under serious consideration in patients eligible for kidney transplantation as soon as there are indications of ultrafiltration failure.

Original languageEnglish
Pages (from-to)619-624
Number of pages6
JournalPeritoneal Dialysis International
Volume27
Issue number6
DOIs
Publication statusPublished - Nov 2007

Bibliographical note

Copyright © 2007 International Society for Peritoneal Dialysis

Research programs

  • EMC MM-04-39-05

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