Length of Time on Peritoneal Dialysis and Encapsulating Peritoneal Sclerosis — Position Paper for ISPD: 2017 Update

Abstract

3. To reach a consensus that should be given to nephrologists and their patients about the length of time that is advisable to remain on PD. GUIDELINES FOR EPSGuidelines on the topic of EPS have been issued by the Japanese Society for Peritoneal Dialysis (8), the UK Renal Association (9), and the Dutch EPS Registry (10). When reading the guidelines, it is clear that issuing evidence-based guidelines on EPS is being hampered by:

Significance of new membrane formation in peritoneal biopsies of peritoneal dialysis patients: a case–control study

“…Patients with peritonitis within 1 month before PD withdrawal (n = 360) were excluded, and 79 of the remaining 769 samples were from patients with medical records indicating that they had been diagnosed with EPS or suspected EPS. We confirmed the diagnosis of EPS based on the Japanese guidelines for EPS [5] and International Society for Peritoneal Dialysis statement [15]. Clinical signs and symptoms of gastrointestinal obstruction were an essential diagnostic criterion of EPS.…”

“…Peritoneal lavage was performed in three patients (no. 1, 3, and 4) for several months (7,15, and 2 months, respectively) before enterolysis surgery to prevent or reduce abdominal adhesions. NFMs were identified microscopically in eight patients (80%) and macroscopically during surgery in two …”

Glükózterhelés a peritonealis dialízisben. Újabb elméleti megfontolások

“…A biokompatibilis oldatokkal kapcsolatos vizsgálatok összegzését követően kibontakozó-ban van az a vélemény, hogy a pH-neutralis, alacsony GDP-tartalmú rezsimek csökkenthetik a jövőben az EPS incidenciáját [14]. A legújabb irányelvek felvetik a PDbizonyos idő utáni -tervezett felfüggesztésének létjogo-sultságát is az EPS megelőzése érdekében [15].…”

Role of Ultrafiltration in Peritoneal Dialysis: A Review

“…This is observed in patients who have recurrent and relapsing peritonitis, sclerosis of the peritoneal membrane (sclerosing peritonitis), and extensive intra-abdominal adhesions. 28 .…”

“…c) Drug therapy: Corticosteroids, Tamoxifen, Immunosuppression -doubtful benefit. d) Surgery -has an important and definitive role in the treatment of EPS and that, in experienced hands, surgery results in high rates of improvement in symptoms and survival 28 .…”