scholarly journals Encapsulated Peritoneal Sclerosis Masquerading as an Abdominal Catastrophe in Peritoneal Dialysis Therapy

Cureus ◽  
2021 ◽  
Author(s):  
Justin Leeoloy ◽  
Mayanka Kambojia ◽  
Aparna Wagle Shukla ◽  
Xuili Liu ◽  
Ashutosh Shukla
1996 ◽  
Vol 16 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Marion Haubitz ◽  
Reinhard Brunkhorst ◽  
Eike Wrenger ◽  
Peter Froese ◽  
Matthias Schulze ◽  
...  

Objective Evaluation of the inflammatory activity in patients on chronic peritoneal dialysis (PD) and patients on chronic hemodialysis (HD) in comparison to patients with chronic renal insufficiency without dialysis treatment and healthy volunteers. Design Open, non randomized prospective study. Setting Nephrology Department, including HD and PD therapy in a university hospital. Patients Twenty -four patients on chronic PD, 21 patients on chronic HD therapy using a cuprophan dialyzer, 16 patients with chronic renal insufficiency without dialysis treatment, and 33 healthy volunteers; 8 additional patients before and after initiation of chronic HD therapy. All patients and controls were without infection or immunosuppressive therapy. Main Outcome Measures As a marker of the inflammatory activity in the different patient groups, C-reactive protein (CAP) was measured serially using a sensitive, enzyme-Iinked, immunosorbent assay in order to detect values below the detection limit of standard assays. Results All patient groups had CAP levels higher than the normal controls (p < 0.01). Patients on HD had CAP levels significantly higher than PD patients (p < 0.01) whose levels were comparable to patients without dialysis therapy. Accordingly, longitudinal measurements before and after initiation of chronic HD showed a significant increase in CAP levels after the beginning of HD treatment (p < 0.04). Conclusions The results suggest that induction of the inflammatory activity is lower during PD compared to HD, since stimulation by the dialyzer membrane, dialysate buffer, or bacterial fragments in the dialysate is avoided. This observation might indicate a possible lower risk of long-term complications in patients with PD.


2002 ◽  
Vol 22 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Tao Wang ◽  
Georgi Abraham ◽  
Takashi Akiba ◽  
Peter Blake ◽  
Ram Gokal ◽  
...  

Nephron ◽  
1984 ◽  
Vol 37 (1) ◽  
pp. 21-24 ◽  
Author(s):  
A. Rodríguez-Carmona ◽  
R. Selgas ◽  
M.E. Martínez ◽  
F. Ortí ◽  
J.L. Miguel ◽  
...  

2019 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nihan Tekkarismaz ◽  
Dilek Torun ◽  
Ruya Ozelsancak ◽  
Hasan Micozkadioglu ◽  
Gürcan Erbay

2012 ◽  
Vol 32 (2) ◽  
pp. 159-167 ◽  
Author(s):  
Nobuhiro Ayuzawa ◽  
Yoshitaka Ishibashi ◽  
Yutaka Takazawa ◽  
Haruki Kume ◽  
Toshiro Fujita

♦BackgroundMorphology changes of the peritoneal membrane after long-term peritoneal dialysis (PD) consist of denudation of peritoneal mesothelial cells, interstitial sclerosis, and hyalinizing vasculopathy. Those changes are considered to be the result of uremia and bioincompatible effects of conventional acidic lactate-buffered dialysate with glucose degradation products (GDPs). In the last decade, biocompatible dialysate with neutral pH and low GDPs has become widely used. Clinical practice has been modified in Japan, especially for anuric patients, and now includes the use of hybrid therapy. The impact on peritoneal morphology has not been well reported.♦ ObjectiveThe aim of the present study was to investigate the long-term effect on peritoneal morphology and function of biocompatible fluid use and current clinical practice in Japan, including hybrid dialysis therapy.♦MethodsWe evaluated peritoneal biopsy specimens from patients who had undergone PD for more than 3 years. We used the average peritoneal thickness (APT) of the submesothelial compact zone as a marker of interstitial sclerosis and the lumen/vessel diameter ratio (L/V ratio) at postcapillary venules as a marker of hyalinizing vasculopathy. Demography and other data for the patients, including dialysate-to-plasma (D/P) ratio of creatinine, were obtained at baseline and every 6 months by peritoneal equilibration test.♦ResultsBetween 2002 and 2009, 110 patients started PD therapy with biocompatible dialysate at Tokyo University Hospital. Among them, 11 patients (8 men, 3 women; age: 54.2 ± 11.8 years; 1 with diabetes mellitus) were enrolled into this morphology study. The mean duration of PD in this group was 61 ± 11.3 months, and the mean time to peritoneal biopsy was 58 ± 15.1 months. The median APT was 180 μm (96 – 1424 μm), and the median L/V ratio was 0.66 (0.46 – 0.74). No obvious correlations between APT, L/V ratio, and PD duration were detected. The D/P creatinine of the 11 patients was maintained at a favorably low value, comparable with that of the other 99 patients.♦ConclusionsPeritoneal dialysis therapy using biocompatible dialysate in conjunction with modification of clinical practice may minimize the progression of peritoneal interstitial sclerosis and hyalinizing vasculopathy, preserving favorable peritoneal function for more than 3 years.


2005 ◽  
Vol 25 (4_suppl) ◽  
pp. 48-56 ◽  
Author(s):  
Masanobu Miyazaki ◽  
Yukio Yuzawa

Encapsulating peritoneal sclerosis (EPS) is a serious complication of long-term continuous peritoneal dialysis therapy. The progression of EPS has been classified into four stages by Kawanishi and colleagues: pre-EPS, and the inflammatory, encapsulating, and ileus stages. The key issue is how to diagnose EPS early enough to allow for curative treatment. In this article, we review the mechanisms of peritoneal fibrosis, especially from the perspective of collagen synthesis, and the potential role of that fibrosis in the pathogenesis of EPS.


2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 143-147
Author(s):  
Graham Woodrow

Loss of sodium and water excretion with disruption of volume homeostasis is a crucial abnormality of end-stage renal failure. Fluid management is a fundamental function of dialysis therapy, but studies show frequent occult fluid overload, hypertension, and cardiac dysfunction in peritoneal dialysis. A rigorous approach to fluid management in PD can achieve excellent fluid, hypertension, and cardiovascular results in clinical practice. The present article explores the reasons for fluid overload and poor ultrafiltration in peritoneal dialysis patients and discusses optimal assessment and management of these problems.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Malgorzata Debowska ◽  
Rafael Gomez ◽  
Joyce Pinto ◽  
Jacek Waniewski ◽  
Bengt Lindholm

Abstract In renal failure, hyperphosphatemia is common and correlates with increased mortality making phosphate removal a key priority for dialysis therapy. We investigated phosphate clearance, removal and serum level, and factors associated with phosphate control in patients undergoing continuous ambulatory (CAPD), continuous cyclic (CCPD) and automated (APD) peritoneal dialysis (PD). In 154 prevalent PD patients (mean age 53.2 ± 17.6 year, 59% men, 47% anuric), 196 daily collections of urine and 368 collections of dialysate were evaluated in terms of renal, peritoneal and total (renal plus peritoneal) phosphorus removal (g/week), phosphate and creatinine clearances (L/week) and urea KT/V. Dialytic removal of phosphorus was lower in APD (1.34 ± 0.62 g/week) than in CAPD (1.89 ± 0.73 g/week) and CCPD (1.91 ± 0.63 g/week) patients; concomitantly, serum phosphorus was higher in APD than in CAPD (5.55 ± 1.61 vs. 4.84 ± 1.23 mg/dL; p < 0.05). Peritoneal and total phosphate clearances correlated with peritoneal (rho = 0.93) and total (rho = 0.85) creatinine clearances (p < 0.001) but less with peritoneal and total urea KT/V (rho = 0.60 and rho = 0.65, respectively, p < 0.001). Phosphate removal, clearance and serum levels differed between PD modalities. CAPD was associated with higher peritoneal removal and lower serum level of phosphate than APD.


Sign in / Sign up

Export Citation Format

Share Document