SP515ENCAPSULATING PERITONEAL SCLEROSIS: A SINGLE-CENTER EXPERIENCE

Abstract

Introduction and Aims: Encapsulating peritoneal sclerosis (EPS) is a rare but potentially fatal complication of peritoneal dialysis (PD) treatment. Excessive sclerotic and fibrotic thickening of the peritoneal membrane. Patients had at least one of these three symptoms: abdominal pain, vomiting and abdominal distension. We presented here fourteen cases who developed EPS among 300 peritoneal dialysis patients that we followed up at last twenty years. Method(s): We have detected in fourteen patients (four female, ten male) with EPS. Mean duration of interval between onset PD and EPS was 125 (78-192) months. The average age was 53.3 (32-66) years. Mean number of peritonitis episode was 3(1-5). Cases are summarized in table. Abbreviations: F, female; M: male; HT, Hypertension; MPGN, Membranoproliferative Glomerulonephritis; CGN, Chronic Glomerulonephritis; PKD, Polycystic Kidney Disease; NL, Nephrolithiasis; PD, Peritoneal Dialysis; UE, Uncertain Etiology. Result(s): Encapsulating peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis (PD). EPS develops as a result of peritoneal irritation. The current leading theory of EPS pathophysiology assumes that a second hit on an inflamed peritoneal membrane may play an important role in the development of EPS. The risk of developing EPS primarily depends on the duration of PD. The main presenting symptoms were abdominal pain, vomiting and/or abdominal distension. Our patients were diagnosed by clinical and radiological findings. Clinical, radiologic and pathologic criteria for EPS diagnosis were defined by the International Society for Peritoneal Dialysis (ISPD). The CT scan aids in the diagnosis of EPS, characteristic findings are such as peritoneal calcifications, peritoneal thickening, bowel tethering and ascites. There are no randomized, controlled trials to guide EPS treatment. Case-series suggest that immunosuppression such as prednisolone, tamoxifen, azathioprine, mycophenolate mofetil can help. The other treatment of EPS is surgery. Conclusion(s): Abdominal pain, ascites, and inadequate dialysis with peritoneal dialysis patients should be considered EPS. The more studies are required to address the clinical problems created by a possible rising incidence of EPS. (Table Presented).