Encapsulating Peritoneal Sclerosis in the New Millennium

Brown, Michaela C.; Simpson, Keith; Kerssens, J.J.; Mactier, Robert

doi:10.2215/cjn.01260209

Cited by 183 publications

(223 citation statements)

References 32 publications

(47 reference statements)

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“…10 EPS is probably a multifactorial disease, in which PD duration represents an important risk factor. [11][12][13] Other conditions that have been inconsistently associated with EPS include cumulative glucose exposure, younger age, peritonitis episodes, b-blockers, and kidney transplantation. [11][12][13] Surprisingly, symptoms of EPS occur after PD withdrawal in most cases.…”

mentioning

confidence: 99%

“…[11][12][13] Other conditions that have been inconsistently associated with EPS include cumulative glucose exposure, younger age, peritonitis episodes, b-blockers, and kidney transplantation. [11][12][13] Surprisingly, symptoms of EPS occur after PD withdrawal in most cases. [11][12][13] There are currently no definitive criteria that enable the detection of early stages of EPS.…”

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confidence: 99%

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Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis

Morelle

Sow

Hautem

et al. 2015

Journal of the American Society of Nephrology

105

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Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of peritoneal dialysis (PD) characterized by extensive fibrosis of the peritoneum. Changes in peritoneal water transport may precede EPS, but the mechanisms and potential predictive value of that transport defect are unknown. Among 234 patients with ESRD who initiated PD at our institution over a 20-year period, 7 subsequently developed EPS. We evaluated changes in peritoneal transport over time on PD in these 7 patients and in 28 matched controls using 3.86% glucose peritoneal equilibration tests. Compared with long-term PD controls, patients with EPS showed early loss of ultrafiltration capacity and sodium sieving before the onset of overt EPS. Multivariate analysis revealed that loss of sodium sieving was the most powerful predictor of EPS. Compared with long-term PD control and uremic peritoneum, EPS peritoneum showed thicker submesothelial fibrosis, with increased collagen density and a greater amount of thick collagen fibers. Reduced osmotic conductance strongly correlated with the degree of peritoneal fibrosis, but not with vasculopathy. Peritoneal fibrosis was paralleled by an excessive upregulation of vascular endothelial growth factor and endothelial nitric oxide synthase, but the expression of endothelial aquaporin-1 water channels was unaltered. Our findings suggest that an early and disproportionate reduction in osmotic conductance during the course of PD is an independent predictor of EPS. This functional change is linked to specific alterations of the collagen matrix in the peritoneal membrane of patients with EPS, thereby validating the serial three-pore membrane/fiber matrix and distributed models of peritoneal transport.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis

Morelle

Sow

Hautem

et al. 2015

Journal of the American Society of Nephrology

105

View full text Add to dashboard Cite

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“…EPS is a rare but potentially devastating complication of PD (8). Recent large prospective cohort studies from Australia, New Zealand, and Scotland suggest that the 8-year cumulative incidence in patients undergoing PD ranges from 4% to 8% (9,10). Although peritoneal fibrosis is common in patients treated with PD, a diagnosis of EPS requires the clinical or radiologic/anatomic evidence for both peritoneal sclerosis and intestinal encapsulation (9).…”

Section: Discussion Of Questionmentioning

confidence: 99%

“…Recent large prospective cohort studies from Australia, New Zealand, and Scotland suggest that the 8-year cumulative incidence in patients undergoing PD ranges from 4% to 8% (9,10). Although peritoneal fibrosis is common in patients treated with PD, a diagnosis of EPS requires the clinical or radiologic/anatomic evidence for both peritoneal sclerosis and intestinal encapsulation (9). EPS should be diagnosed only in patients with suggestive clinical features with consistent radiologic or anatomic (intraoperative) findings.…”

Section: Discussion Of Questionmentioning

confidence: 99%

American Society of Nephrology Quiz and Questionnaire 2012

Mehrotra

Glassock

Bleyer

2013

Clinical Journal of the American Society of Nephrology

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SummaryPresentation of the Nephrology Quiz and Questionnaire has become an annual tradition at the meetings of the American Society of Nephrology. It is a very popular session judged by consistently large attendance. Members of the audience test their knowledge and judgment on a series of case-oriented questions prepared and discussed by experts. They can also compare their answers in real time, using audience response devices, with the answers of program directors of nephrology training programs in the United States acquired through an Internet-based questionnaire. Topics presented here include fluid and electrolyte disorders, glomerular diseases, transplantation, and ESRD and dialysis. Cases representing each of these categories along with single best answer questions were prepared by a panel of experts (Drs. Palmer, Fervenza, and Brennan and Mehrotra, respectively). The correct and incorrect answers then were briefly discussed after the audience responses, and the results of the questionnaire were displayed. This article tries to recapitulate the session and reproduce its educational value for a larger audience-the readers of the CJASN.

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“…A Scottish study, also showed that the incidence of encapsulating peritonitis increases with time on PD 4 .…”

Section: Introductionmentioning

confidence: 92%

The influence of simvastatin in induced peritoneal fibrosis in rats by peritoneal dialysis solution with glucosis 4.25%

et al. 2012

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PURPOSE: To investigate the influence of using simvastatin on the peritoneal fibrosis induced in rats using peritoneal dialysis solution with glucoses 4.25%. METHODS: Prospective controlled study in 20 non-uremic Wistar rats. The animals received a peritoneal infusion of 10 ml/100 g of peritoneal dialysis solution glucose 4.25% on a daily basis. The animals were divided in two groups: experimental and control. The experimental group received simvastatin 4 mg/kg/d, by a gastric tube. The control group did not receive any drug. The follow-up was 21 and 49 days. At the end, one surgical procedure was performed to get histological samples of visceral and parietal peritoneum. The samples were analyzed using Hematoxylin Eosin and Sirius Red, to evaluate the severity of the fibrosis. RESULTS: The analysis showed that the intensity of the fibrosis, the peritoneal thickness and the cell number in experimental and control groups were not statistically significant different in experimental and control groups. CONCLUSION: The simvastatin do not decrease the intensity of fibrosis on the peritoneal membrane that happens on rats on peritoneal dialysis.

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Encapsulating Peritoneal Sclerosis in the New Millennium

Cited by 183 publications

References 32 publications

Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis

Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis

American Society of Nephrology Quiz and Questionnaire 2012

The influence of simvastatin in induced peritoneal fibrosis in rats by peritoneal dialysis solution with glucosis 4.25%

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