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Long-term peritoneal dialysis and encapsulating peritoneal sclerosis in children Honda M; Warady BAPediatr Nephrol 2010[Jan]; 25 (1): 75-81Encapsulating peritoneal sclerosis (EPS) is the most serious complication of long-term peritoneal dialysis (PD), with a mortality rate that exceeds 30%. There have been many reports of the incidence of EPS being strongly correlated to the duration of PD. Patients on PD for longer than 5 years, and especially those receiving this treatment for more than 8 years, should undergo careful and repeated surveillance for risk factors associated with the development of EPS. The development of ultrafiltration failure, a high dialysate/plasma creatinine ratio, as determined by the peritoneal equilibration test, peritoneal calcification, a persistently elevated C-reactive protein level, and severe peritonitis in patients on PD for longer than 8 years are signals that should prompt the clinician to consider terminating PD as a possible means of preventing the development of EPS. The impact of the newer, biocompatible PD solutions on the incidence of EPS has not yet been determined.|Adolescent[MESH]|Child[MESH]|Humans[MESH]|Japan/epidemiology[MESH]|Peritoneal Dialysis/*adverse effects[MESH]|Peritoneal Fibrosis/*etiology/mortality/prevention & control[MESH]|Peritonitis/epidemiology/etiology[MESH]|Survival Rate[MESH]|Withholding Treatment[MESH] |
