Encapsulated peritoneal sclerosis: A single center, retrospective analysis of clinical manifestations, risk factors and prognosis
Minerva Urologica e Nefrologica, cilt.70, sa.4, ss.429-436, 2018 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 70 Sayı: 4
- Basım Tarihi: 2018
- Doi Numarası: 10.23736/s0393-2249.18.03057-6
- Dergi Adı: Minerva Urologica e Nefrologica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.429-436
- Anahtar Kelimeler: Peritonitis, Peritoneal fibrosis, Complications
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
BACKGROUND: Encapsulated peritoneal sclerosis (EPS) is a multifactorial chronic intra-abdominal inflammatory disorder affecting the peritoneum diffusely. The aim of this study was to evaluate the rates of EPS in our peritoneal dialysis (PD) population, to perform a general assessment of the clinical presentation and to determine the outcome of affected patients and risk factors. METHODS: The medical records of consecutive 384 patients who started PD therapy between January 2001 and Novem¬ ber 2016 were evaluated. Socio-demographic characteristics, comorbidities, PD therapy details and infectious complica¬ tions were recorded. Medical records were examined to make sure that the cases met the ISPD criteria for EPS diagnosis including clinical features and either radiological and/or histopathological confirmation. Patients diagnosed with EPS were identified, and the incidence, clinical presentation, treatments and recent status of the patients were reviewed. Fac¬ tors that might be associated with EPS formation and mortality were investigated. RESULTS: Two hundred one of 384 patients were female, mean age was 45.9±15.6 years and mean PD follow up time were 42.6±35 months. EPS was developed in 26 patients and EPS development rate was 6.7%. PD follow-up period and duration of hypertonic solution usage were longer in patients with EPS (P<0.001 and P=0.017 respectively). Patients with and without EPS were similar in terms of modality (P=0.21) but treatment duration with APD modality was longer in patients with EPS (P<0.001). The PD follow-up period was found to be a predictor of EPS formation (P<0.001, RR:1.034 [95% CI: 1.020-1.047]). Age (P<0.001, RR:1.039 (95% CI: 1.024-1.053) and use of hypertonic dialysis solution (P=0.007, RR:0.979 (95% CI: 0.965-0.994)) were the factors affecting survival in EPS patients. CONCLUSIONS: EPS is a relatively rare but fatal complication of peritoneal dialysis and extension of PD duration is a risk for EPS formation. Younger age and usage of hypertonic dialysis solution affects mortality in patients with EPS.