Towards Standardized Reporting in Studies of Encapsulating Peritoneal Sclerosis

Lambie, Mark; Braun, Niko; Davies, Simon

doi:10.3747/pdi.2013.00165

Cited by 6 publications

(6 citation statements)

References 20 publications

(32 reference statements)

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“…We agree with the current belief that the diagnostic criteria need to be standardized to allow proper comparative studies to proceed [ 9 ]. One suggestion is to only include patients with overt bowel obstruction, but it may be difficult to define obstruction [ 22 ].…”

Section: Discussionsupporting

confidence: 79%

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Incidence and outcome of encapsulating peritoneal sclerosis

Petrie¹,

Traynor²,

Mactier³

2016

Clin Kidney J

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BackgroundStudies report variation in the incidence and outcomes of encapsulating peritoneal sclerosis (EPS). This study reports the incidence and outcome of EPS cases in a national cohort of peritoneal dialysis (PD) patients.MethodsThe incident cohort of adult patients who started PD between 1 January 2000 and 31 December 2007 in Scotland (n = 1238) was identified from the Scottish Renal Registry. All renal units in Scotland identified potential EPS cases diagnosed from 1 January 2000 to 31 December 2014, by which point all patients had a minimum of 7 years follow-up from start of PD.ResultsBy 31 December 2014, 35 EPS cases were diagnosed in the 1238 patient cohort: an overall incidence of 2.8%. The incidence for subgroups with longer PD duration rises exponentially: 1.1% by 1 year, 3.4% by 3 years, 8.8% at 4 years, 9.4% at 5 years and 22.2% by 7 years. Outcomes are poor with mortality of 57.1% by 1 year after diagnosis. Survival analysis demonstrates an initial above-average survival in patients who later develop EPS, which plummets to well below average after EPS diagnosis.ConclusionsThe incidence of EPS is reassuringly low provided PD exposure is not prolonged and this supports ongoing use of PD. However, continuing PD beyond 3 years results in an exponential rise in the risk of developing EPS and deciding whether this risk is acceptable should be made on an individual patient basis.

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Section: Discussionsupporting

confidence: 79%

“…The intention of our work was to achieve this in the Scottish PD population, quantifying the incidence and recording the outcome of EPS cases using the ISPD diagnostic criteria [ 8 ]. There is a view that these criteria should be refined to improve consistency of diagnosis between studies and avoid potential over-reporting [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and outcome of encapsulating peritoneal sclerosis

Petrie¹,

Traynor²,

Mactier³

2016

Clin Kidney J

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“…osmotic conductance or glucose exposure during PD) [49] . We were unable to fully comply with suggested standards for reporting clinical features of EPS as the data was collected prospectively, before the standards were suggested [50] . Survival was not significantly different between the groups, even so there was a trend towards a better outcome in the PT-EPS group (p = 0.3).…”

Section: Discussionmentioning

confidence: 99%

Histological and Clinical Findings in Patients with Post-Transplantation and Classical Encapsulating Peritoneal Sclerosis: A European Multicenter Study

et al. 2014

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BackgroundEncapsulating peritoneal sclerosis (EPS) commonly presents after peritoneal dialysis has been stopped, either post-transplantation (PT-EPS) or after switching to hemodialysis (classical EPS, cEPS). The aim of the present study was to investigate whether PT-EPS and cEPS differ in morphology and clinical course.MethodsIn this European multicenter study we included fifty-six EPS patients, retrospectively paired-matched for peritoneal dialysis (PD) duration. Twenty-eight patients developed EPS after renal transplantation, whereas the other twenty-eight patients were classical EPS patients. Demographic data, PD details, and course of disease were documented. Peritoneal biopsies of all patients were investigated using histological criteria.ResultsEighteen patients from the Netherlands and thirty-eight patients from Germany were included. Time on PD was 78(64–95) in the PT-EPS and 72(50–89) months in the cEPS group (p>0.05). There were no significant differences between the morphological findings of cEPS and PT-EPS. Podoplanin positive cells were a prominent feature in both groups, but with a similar distribution of the podoplanin patterns. Time between cessation of PD to the clinical diagnosis of EPS was significantly shorter in the PT-EPS group as compared to cEPS (4(2–9) months versus 23(7–24) months, p<0.001). Peritonitis rate was significantly higher in cEPS.ConclusionsIn peritoneal biopsies PT-EPS and cEPS are not distinguishable by histomorphology and immunohistochemistry, which argues against different entities. The critical phase for PT-EPS is during the first year after transplantation and therefore earlier after PD cessation then in cEPS.

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“…There is no gold standard for the diagnosis of EPS, and it is recommended that the condition is diagnosed by the presence of the combination of characteristic clinical and radiological features [ 160 , 161 ]. A challenge in this is that there is significant heterogeneity in the condition with variation of severity and extent of peritoneal involvement [ 156 , 162 , 163 ]. The epidemiology, clinical features, investigation and management of EPS in paediatric patients is similar to that in adults [ 164 , 165 ].…”

Section: Rationale For Clinical Practice Guidelines For Peritoneal DImentioning

confidence: 99%

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

Woodrow

Fan

Reid³

et al. 2017

BMC Nephrol

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These guidelines cover all aspects of the care of patients who are treated with peritoneal dialysis. This includes equipment and resources, preparation for peritoneal dialysis, and adequacy of dialysis (both in terms of removing waste products and fluid), preventing and treating infections. There is also a section on diagnosis and treatment of encapsulating peritoneal sclerosis, a rare but serious complication of peritoneal dialysis where fibrotic (scar) tissue forms around the intestine. The guidelines include recommendations for infants and children, for whom peritoneal dialysis is recommended over haemodialysis.Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and A-D depending on the quality of the evidence that the recommendation is based on.

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Towards Standardized Reporting in Studies of Encapsulating Peritoneal Sclerosis

Cited by 6 publications

References 20 publications

Incidence and outcome of encapsulating peritoneal sclerosis

Incidence and outcome of encapsulating peritoneal sclerosis

Histological and Clinical Findings in Patients with Post-Transplantation and Classical Encapsulating Peritoneal Sclerosis: A European Multicenter Study

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

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