No need for an “expiry date” in chronic peritoneal dialysis to prevent encapsulating peritoneal sclerosis

Garosi, Guido; Oreopoulos, Dimitrios G.

doi:10.1007/s11255-009-9661-7

Cited by 20 publications

(13 citation statements)

References 38 publications

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“…The clinical implication is that a prolonged clinical vigilance and a high index of suspicion for the diagnosis are warranted. Furthermore, our findings contribute to the ongoing discussion whether young PD patients should prematurely be transferred to HD after a few years of PD while awaiting transplantation or after transplant failure (20,21).…”

Section: Discussionmentioning

confidence: 65%

Posttransplantation Encapsulating Peritoneal Sclerosis Contributes Significantly to Mortality after Kidney Transplantation

Korte

Habib

Lingsma

et al. 2011

American Journal of Transplantation

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Encapsulating peritoneal sclerosis (EPS) is a severe complication of peritoneal dialysis (PD) and may present after kidney transplantation, a condition known as posttransplantation EPS. The prevalence and impact of posttransplantation EPS on survival after kidney transplantation is unknown. From January 1, 1996 until July 1, 2007, 1241 PD patients were transplanted. Thirty-eight cases of posttransplantation EPS (3%) were identified from the Dutch multicenter EPS study. In EPS patients the mean pretransplant dialysis duration was longer than in the controls (71.4 ± 37.5 months vs. 34.7 ± 25.5, p < 0.0001). The majority of EPS cases were observed within the first 2 years after transplantation, but some cases appeared many years after transplantation. Two hundred and one (16.2%) patients died after transplantation, of which 17 were EPS patients. After infection (23.9%), cardiovascular disease (21.9%) and malignancy (10.9%), EPS (8.5%) was the fourth known cause of death after transplantation. Kaplan-Meier analysis showed a significant decreased survival for transplanted patients with posttransplantation EPS compared to transplanted patients without EPS. In conclusion, posttransplantation EPS is rare but carries a high mortality. A prolonged clinical vigilance and a high index of suspicion for the diagnosis are warranted, specifically in PD patients with a relatively long cumulative pretransplant duration of PD.

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Section: Discussionmentioning

confidence: 65%

Posttransplantation Encapsulating Peritoneal Sclerosis Contributes Significantly to Mortality after Kidney Transplantation

Korte

Habib

Lingsma

et al. 2011

American Journal of Transplantation

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“…There is no clear consensus regarding the optimal time on PD (27). It is obvious that shifting the patient to HD when necessary rather than continuing a therapy that is becoming dangerous will affect the patient's survival.…”

Section: Discussionmentioning

confidence: 99%

Is Assisted Peritoneal Dialysis Associated with Technique Survival When Competing Events Are Considered?

Lobbedez

Verger²,

Ryckelynck

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives This study assessed whether assisted peritoneal dialysis (PD) was associated with a lower risk for technique failure using methods developed for survival analysis in the presence of competing risks. Results There were 5286 patients undergoing assisted PD; 4230 of these were assisted by a community nurse and 1056 by family. Assisted PD patients were older and had a higher Charlson comorbidity index than self-care PD patients. There were 7594 events: 3495 deaths, 2464 transfers to hemodialysis, 1489 renal transplantations, and 146 renal function recoveries. According to a Cox model, assistance and center size were associated with a lower risk for technique failure, whereas hemodialysis before PD, early peritonitis, and transplantation failure were associated with a higher risk for transfer to hemodialysis. A Fine and Gray regression model showed that assisted PD was associated with a lower risk for transfer to hemodialysis. ConclusionsCompared with patients undergoing self-care PD, those with assisted PD had a lower risk for transfer to hemodialysis, a higher risk for death, and a lower risk for transplantation.

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“…8 The medical therapy of EPS consists of bowel rest using total parenteral nutrition (TPN), corticosteroids, tamoxifen and immunosuppressive agents with recent use of inhibitors of mammalian target of rapamycin (mTOR) and avoiding or minimization of CNI administrations in patients with history of PD treatment. [9][10][11] Two experimental studies on chlorhexidine gluconate 0.1% EPS model showed that oral mTOR inhibitors (sirolimus and everolimus) significantly reduced peritoneal thickness, vascularity and fibrosis score. 12,13 This effect of mTOR inhibitors on the peritoneum was mediated by inhibition of fibrosis and neoangiogenesis through various molecular mechanisms including increased expression of E-cadherin (a protective gene for EMT) and decreased a-smooth muscle actin (a-SMA).…”

Section: Introductionmentioning

confidence: 99%

mTOR inhibitors for management of encapsulating peritoneal sclerosis: a review of literatures

2016

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No need for an “expiry date” in chronic peritoneal dialysis to prevent encapsulating peritoneal sclerosis

Cited by 20 publications

References 38 publications

Posttransplantation Encapsulating Peritoneal Sclerosis Contributes Significantly to Mortality after Kidney Transplantation

Posttransplantation Encapsulating Peritoneal Sclerosis Contributes Significantly to Mortality after Kidney Transplantation

Is Assisted Peritoneal Dialysis Associated with Technique Survival When Competing Events Are Considered?

mTOR inhibitors for management of encapsulating peritoneal sclerosis: a review of literatures

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