The dose conversion ratio of 1:200 was unsuitable and led to a rapid increase of hemoglobin. A conversion ratio of 1:250 to 1:300 should be employed when switching from epoetin alpha to darbepoetin alpha in Japanese patients.

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Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of peritoneal dialysis (PD). Involvement of the inflammation is indispensable as the EPS emission factor. We experienced the surgery of the EPS‐like case that emits it to the hemodialysis (HD) patient without the PD. Patient: In November 1996 the patients, a 47‐year old male developed end‐stage renal failure due to chronic nephritis and started HD. Before and during HD, he complicated alcohol liver cirrhosis with ascites. In September 2001 he had intestinal obstructive symptoms and recovered with repeated puncture and drainage of ascites. Abdominal CT examination revealed the intestine oppression by the ascites with thick tunic formation. At May 2002, he underwent a laparotomy. Thick capsules formed surroundings to the ascites. This capsules covered parietal peritoneum and intestine surface and oppressed the intestine. The total ablation of small intestine was succeeded. Ascites examinations IL‐6 20,350 pg/mL FDP 80 micro‐g/mL TAT 1090 micro‐g/L, was suspected to conjecture the involvement of inflammation and coagulate‐fibrinolysis. Histology of peritoneum showed absence of mesothelium but not fibrosis and sclerosis. Discussion: EPS is caused by the inflammation on the deteriorated peritoneum, resulting in encapsulation after the accumulation of inflammatory products such as fibrin. Even if there is not the peritoneum deterioration, chronic inflammation and stimulation that continues for long‐time causing EPS‐like findings with encapsulation. The encapsulating ileus findings irrespective of the peritoneum deterioration should call with encapsulated peritonitis (EP).

Abstract Background Management of vascular access (VA) is essential in hemodialysis (HD) patients. However, VA often fails and percutaneous transluminal angioplasty (PTA) is required. Conventional hemostasis at the puncture site is associated with complications. This study aimed to analyze the efficacy and safety of a hemostatic wound dressing made of calcium alginate at the puncture site of VA after PTA and evaluate other factors affecting hemostasis. Methods After PTA for VA, 200 HD patients were randomized to a calcium alginate sheet (CA) group (n = 100) or a no drug-eluting sheet (control) group (n = 100). We recorded time to hemostasis at the puncture site every 5 min, noting any complications. Results In the CA group, rates of hemostatic achievement at 5, 10, 15 and >15 min were 57, 25, 8 and 10%, respectively. In the control group, the rates were 39, 28, 14 and 19%, respectively. Rates of hemostatic achievement at 5 min were significantly higher in the CA group (P = 0.01). In logistic regression analysis, factors affecting hemostasis within 5 min were use of the CA sheet [odds ratio (OR) 2.33; 95% confidence interval (CI) 1.26–4.37], platelet count ≤100 000/μL (OR 0.19; 95% CI 0.04–0.69), number of antithrombotic tablets used per day ≥1 tablet (OR 0.50; 95% CI 0.26–0.94) and upper arm VA (OR 0.16; 95% CI 0.03–0.55). Conclusions A CA sheet can safely reduce time to hemostasis at the puncture site after PTA, and should be considered for treating patients with a bleeding tendency.