Journal of Nephrology

, Volume 29, Issue 2, pp 259–267 | Cite as

Encapsulating peritoneal sclerosis in an Italian center: thirty year experience

  • Valerio Vizzardi
  • Massimo Sandrini
  • Silvia Zecchini
  • Sara Ravera
  • Luigi Manili
  • Giovanni Cancarini
Original Article

Abstract

Background

Encapsulating peritoneal sclerosis (EPS) is a rare but life-threatening complication of peritoneal dialysis (PD). Its incidence and prevalence are still not clearly defined. No data exist on the prevalence of EPS in Italy.

Objectives

To evaluate the incidence and prevalence of EPS, and identify potential factors useful for prevention or early diagnosis of EPS.

Methods

A retrospective study in patients starting PD between 1979 and 2013 in one Italian center. Data on demographics, occurrence of EPS, time on PD, peritoneal equilibration test, and therapy for EPS were gathered.

Results

EPS occurred in 26/920 patients with a prevalence of 2.8 % and incidence of 1/105 patient-years. The prevalence increased with the time spent on PD: 0.4 % for PD duration <2 years, 3 % (2–4 years), 4 % (4–6 years), 6 % (6–8 years), 8 % (8–10 years), 18 % (10–12 years), 75 % (12–14 years), 67 % (>14 years). EPS prevalence was not higher in PD patients transplanted: 5/172 (2.9 %); only two of them (1.2 %) were diagnosed while with a functioning graft. In only one patient (0.6 %) was the diagnosis made during hemodialysis; the other 23 were diagnosed while still on PD. Mortality due to EPS was 38.5 %, and was associated with PD duration. Therapy with steroids reduced mortality [hazard ratio 0.047 (95 % CI: 0.008–0.273); p < 0.001].

Conclusions

In our experience the prevalence of EPS is low, but increases progressively with the duration of PD. The transfer to hemodialysis or transplantation does not appear to be a key factor for EPS. Therapy with steroids significantly improves the outcome.

Keywords

Encapsulating peritoneal sclerosis Peritoneal dialysis Abdominal cocoon Peritonitis Dialysis 

Notes

Compliance with ethical standards

Conflict of interest

All the authors disclose no conflict of interest with the topic and the content of this paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Italian Society of Nephrology 2015

Authors and Affiliations

  • Valerio Vizzardi
    • 1
  • Massimo Sandrini
    • 1
  • Silvia Zecchini
    • 1
  • Sara Ravera
    • 1
  • Luigi Manili
    • 1
  • Giovanni Cancarini
    • 1
  1. 1.Operative Unit of NephrologyA. O. Spedali Civili of Brescia and University of BresciaBresciaItaly

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