Article Figures & Data
Figures
- Figure 1.
Cumulative risk function of developing EPS according to days since first PD exposure between January 1, 2000, and December 31, 2007.
- Figure 2.
(A) PD Duration: Non-EPS cohort first exposed to PD after January 1, 2000 (n = 1219). (B) PD Duration: EPS cases first exposed to PD after January 1, 2000 (n = 19).
- Figure 3.
Kaplan-Meier survival plots of patients from start of PD for EPS cases (n = 19) and unaffected cohort (n = 1219).
Tables
- Table 1.
Incidence rates of EPS related to total duration of PD exposure (not necessarily continuous)
PD Exposure (years) PD Patients at Risk (n) EPS Cases (n) Incidence (%) 95% Confidence Intervals (%) <1 480 0 0 – 1–2 326 2 0.6 0.2–2.1 >2–3 202 4 2.0 0.8–5.0 >3–4 114 4 3.5 1.4–8.7 >4–5 62 5 8.1 3.6–17.6 >5–6 34 3 8.8 3.2–23.1 >6 20 1 5.0 1.2–23.8 Total 1238 19 EPS, encapsulating peritoneal sclerosis; PD, peritoneal dialysis.
Study Nomoto et al. Japan 1996 Rigby et al. Australia 1998 Lee et al. Korea 2003 Kawanishi et al. Japan 2001 Kawanishi et al. Japan 2004 Summers et al. UK 2005 Brown et al. UK (current study) Number of EPS Casesa 62 54 (46) 31 17 48 27 (23) 46 Dates of Study 1980–1994 1980–1994 1981–2002 1999–2001 1999–2003 1998–2003 2000–2007 Study Design Retrospective Multi-center Retrospective Multi-center Retrospective Multi-center Prospective Multi-center Prospective Multi-center Retrospective Single-center Retrospective Multi-center Denominator Populationb 6923 7374 3888 2216 1958 810 1638 Overall Rate 0.9% 0.7% 0.8% 0.8% 2.5% 3.3% 2.8% Mean PD Exposure (yrs) 5.1 4.3 5.8 10 4.3 6.1 5.4 Mortality (over study period) 43.5% 56% 25.8% 35% 37.5% 29.6% 56.5% - Table 3.
Underlying cause of renal failure of the EPS cases and incident PD population 2000-2007 (GN = glomerulonephritis)
Cause of Renal Failure PD Cohort (N) PD Cohort (%) EPS Group A (N) EPS Group A (%) EPS Group B (N) EPS Group B (%) CRF, uncertain etiology 219 18.0 8 17.4 4 21.1 Diabetes Type I (insulin dependent) 186 15.3 1 2.2 1 5.3 Autosomal Dominant Polycystic Kidney Disease 131 10.7 5 10.9 3 15.8 Pyelonephritis with Urinary Tract Disease 128 10.5 7 15.2 1 5.3 Renovascular Disease 126 10.3 1 2.2 Chronic GN (unspecified) 67 5.5 4 8.7 2 10.5 Diabetes Type II (non insulin dependent) 66 5.4 1 2.2 1 5.3 IgA Nephropathy 63 5.2 3 6.5 2 10.5 Other 56 4.6 4 8.7 1 5.3 Multisystem Disorders 52 4.3 1 2.2 Membranous Nephropathy 24 2.0 2 4.3 Myeloma/Light Chain Deposition Disease 22 1.8 Focal Segment Glomerulosclerosis 15 1.2 5 10.9 3 15.8 Drug-induced Nephropathy 17 1.4 Amyloidosis 15 1.2 Herediatry Nephropahy (inc. Alport's) 12 1.0 2 4.3 1 5.3 Rapidly Progressive/Crescentic GN 11 0.9 1 2.2 Membranoproliferative GN 9 0.7 1 2.2 Total 1219 100 46 100 19 100 EPS, encapsulating peritoneal sclerosis; PD, peritoneal dialysis.
- Table 4.
Main clinical features and radiological abnormalities found in the 46 cases of EPS diagnosed in Scotland 2000-2007
Clinical Features (Most cases had >1) N Imaging Findings (US or CT scan) (some cases had >1) N Abdominal Pain 30 Ascites 33 Vomiting 28 Septate/loculated ascites 22 Weight Loss 24 Peritoneal thickening 14 Ascites 15 Peritoneal calcification 11 Elevated Inflammatory Markers 14 Bowel obstruction 3 Bowel Obstruction 11 Matted/tethered bowel 10 Hypoalbuminaemia 10 Dilated Small Bowel 4 Unexplained Anaemia 10 Bloody Ascites/Dialysate 4 Abdominal Mass 4 Diarrhoea 4 EPS, encapsulating peritoneal sclerosis.
- Table 5.
Total creatinine clearance (renal and PD clearance combined) for EPS cases within 6 mo before stopping PD compared to Scottish PD patients’ achieved clearance from Scottish Renal Registry data 2000-2007
Total Clearance (L/wk) EPS Cases (N) EPS Cases (%) PD Population 2000–2007 (%) <50 5 10.9 5.7 >50-60 12 26.1 11.0 >60-70 14 30.4 16.0 >70 14 30.4 67.0 Unknown 1 2.2 0.0 Total 46 100.0 100.0 EPS, encapsulating peritoneal sclerosis; PD, peritoneal dialysis.
- Table 6.
Reasons for stopping PD in the EPS cases and the Scottish PD population from Scottish Renal Registry data 2000-2007
Reason for Stopping PD EPS Cases (N) EPS Cases (%) PD Population 2000-2007 (%) P value Peritonitis 15 32.6 24.3 0.2 Ultrafiltration Failure 6 13.0 2.3 <0.001 Inadequate Dialysis 9 19.6 11.7 0.03 Failed Access — — 5.3 — High Intra—abdominal Pressure — — 4.5 — Transplant 7 15.2 20.1 0.4 Patient Choice 1 2.2 7.5 0.2 Death — — 24.3 <0.001 EPS 8 17.4 — — Total 46.0 100.0 100.0 EPS, encapsulating peritoneal sclerosis; PD, peritoneal dialysis.
Treatment/Transplant Status No. of Cases Tamoxifen only 6 Sirolimus 3a Prednisolone + Tamoxifen 4 Tamoxifen + Azathioprine 1 Prednisolone + Azathioprine 1 Functioning transplant (Tamoxifen added) 6 Transplanted <4 months post-diagnosis 4 Total treated with Tamoxifen 13 Total Treated with immunosuppression 24 EPS, encapsulating peritoneal sclerosis.
↵a For one of the three treated with Sirolimus it was commenced as part of posttransplant immunosuppressive therapy.
In this issue
Encapsulating Peritoneal Sclerosis in the New Millennium: A National Cohort Study
Jump to section
More in this TOC Section
Cited By...
- Early Detection of Imminent Encapsulating Peritoneal Sclerosis: Free Water Transport, Selected Effluent Proteins, or Both?
- Absence of Post-Transplantation Encapsulating Peritoneal Sclerosis after Relatively Short Exposure to Peritoneal Dialysis: Prospective Analysis Using Repeated Abdominal CT Scanning
- Length of Time on Peritoneal Dialysis and Encapsulating Peritoneal Sclerosis -- Position Paper for ISPD: 2017 Update
- Symptom Management of the Patient with CKD: The Role of Dialysis
- The Current State of Peritoneal Dialysis
- Higher Dialysate Matrix Metalloproteinase-2 Levels Are Associated with Peritoneal Membrane Dysfunction
- Interstitial Fibrosis Restricts Osmotic Water Transport in Encapsulating Peritoneal Sclerosis
- Genetic Polymorphisms and Peritoneal Membrane Function
- Encapsulating Peritoneal Sclerosis in the Era of a Multi-Disciplinary Approach Based on Biocompatible Solutions: the NEXT-PD Study
- Living with Encapsulating Peritoneal Sclerosis (EPS): The Patient's Perspective
- Is There an End in Sight for Encapsulating Peritoneal Sclerosis?
- Dialysate Cytokine Levels Do Not Predict Encapsulating Peritoneal Sclerosis
- Can EPS Development Be Avoided with Early Interventions? The Potential Role of Tamoxifen--A Single-Center Study
- Gadolinium Deposits Could Influence the Course of Encapsulating Peritoneal Sclerosis
- American Society of Nephrology Quiz and Questionnaire 2012: Renal Replacement Therapy
- Phenotypes of Encapsulating Peritoneal Sclerosis--Macroscopic Appearance, Histologic Findings, and Outcome
- Persistent Sterile Peritoneal Inflammation After Catheter Removal for Refractory Bacterial Peritonitis Predicts Full-Blown Encapsulating Peritoneal Sclerosis
- Towards Standardized Reporting in Studies of Encapsulating Peritoneal Sclerosis
- Old and New Perspectives on Peritoneal Dialysis in Italy Emerging from the Peritoneal Dialysis Study Group Census
- Canadian Society of Nephrology Guidelines/Recommendations on Peritoneal Dialysis Adequacy 2011--Response to Comments by Liakopoulos et al.
- FLUID FLOW STRESS AFFECTS PERITONEAL CELL KINETICS: POSSIBLE PATHOGENESIS OF PERITONEAL FIBROSIS
- INCIDENCE OF ENCAPSULATING PERITONEAL SCLEROSIS: A SINGLE-CENTER EXPERIENCE WITH LONG-TERM PERITONEAL DIALYSIS IN THE UNITED STATES
- EXPLORING THE ASSOCIATION BETWEEN ICODEXTRIN AND ENCAPSULATING PERITONEAL SCLEROSIS
- RISK FACTORS ASSOCIATED WITH ENCAPSULATING PERITONEAL SCLEROSIS IN DUTCH EPS STUDY
- DIFFERENCE IN THE EXPRESSION OF HORMONE RECEPTORS AND FIBROTIC MARKERS IN THE HUMAN PERITONEUM--IMPLICATIONS FOR THERAPEUTIC TARGETS TO PREVENT ENCAPSULATING PERITONEAL SCLEROSIS
- A COLLABORATIVE APPROACH TO UNDERSTANDING EPS: THE EUROPEAN PERSPECTIVE
- IS ENCAPSULATING PERITONEAL SCLEROSIS RARE IN NORTH AMERICA?
- Back to the Future: Changes in the Dialysis Delivery Model in the UK
- LENGTH OF TIME ON PERITONEAL DIALYSIS AND ENCAPSULATING PERITONEAL SCLEROSIS: POSITION PAPER FOR ISPD