Encapsulating Peritoneal Sclerosis: An Experience From A Single Korean University Center

The aim of this study was to investigate the incidence and clinical features of EPS in PD patients from a single university center in Korea. The data were retrospectively collected from 606 prevalent PD patients between August 2001 and August 2011. The diagnosis of EPS was based on clinical signs and symptoms, mostly confirmed by radiological findings.Eight patients (incidence rate of 1.3%) were diagnosed with EPS. They had at least one of three symptoms: abdominal pain, vomiting, or abdominal distension. Mean age of the patients (4 males and 4 females) was 48.5 (range: 33 to 65) years. Mean duration of PD was 111.8 (range: 23 to 186) months. The causes of ESRD were chronic glomerulonephritis (n=6), followed by hypertensive nephrosclerosis (n=1) and diabetic nephropathy (n=1). All the patients except one had 3 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. The use of icodextrin or beta-blockers and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers was not different in the patients without EPS. Total parenteral nutrition was used in all patients. Three patients were treated with corticosteroids (0.5∼1 mg/kg/day) in addition to tamoxifen (10–20 mg daily) and four with only total parenteral nutrition. Only one patient received corticosteroids (1 mg/kg/day) combined with elective surgical intervention, adhesiolysis. Of the 8 patients diagnosed with EPS, 4 died with an overall mortality rate of 50%.In this retrospective analysis, we confirmed that EPS is rare but a serious life threatening complication in patients on long-term PD. To reduce the incidence and mortality of EPS, careful monitoring and early diagnosis may be needed