2026-04-10T00:15:23Z https://www.peertechzpublications.org/oai-pmh

oai:www.peertechzpublications.org:10.17352/acn.000025 2017-10-05 PTZ.ACN:VOL3

Encapsulating Peritoneal Sclerosis: Case report and Current Status Jacques RottembourgBelkacem Issad<p>Encapsulating peritoneal sclerosis (EPS), is a rare but devastating complication of long-term peritoneal dialysis (PD) with a high mortality rate. The incidence is between 0.5 and 3.3%, decreasing with time. EPS is defi ned as a clinical syndrome with major signs of gastrointestinal obstruction, infl ammatory parameters, radiological and macroscopic changes. Duration of treatment and cessation of PD are the main risk for development of EPS: about 75% of EPS occurred in patients transferred on hemodialysis or in the two years after kidney transplantation. Morphological alterations are disappearance of mesothelial layer, sub-mesothelial fi brosis, interstitial sclerosis and vasculopathy, ultrafi ltration failure, fast transport status of the peritoneal membrane, and loss of sodium sieving are the most predicting functional&nbsp; abnormalities. Some biomarkers could be found in the peritoneal effl uent. The pathophysiology is probably a consequence of a multiple-hit process in which expression of growth factors and cytokines play a role. Medical strategies (corticosteroids, immunosuppressive drugs, tamoxifen) in association with parenteral nutrition and/or surgery (enterolysis) are discussed. Prevention is the use of physiological peritoneal solutions, icodextrine instead of high glucose concentration solution, and peritoneal lavage fter peritoneal dialysis cessation for any reason.</p> Archives of Clinical Nephrology - Peertechz Publications 2017-10-05 Case Report https://doi.org/10.17352/acn.000025 en Copyright © Jacques Rottembourg et al.