Long-term peritoneal dialysis and encapsulating peritoneal sclerosis in children |
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Authors: | Masataka Honda Bradley A. Warady |
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Affiliation: | (1) Department of Pediatric Nephrology, Tokyo Metropolitan Children’s Hospital, Umezono 1–3–1, Kiyoseshi, Tokyo 204–8567, Japan;(2) Pediatric Nephrology, The Children’s Mercy Hospital, Kansas City, Missouri, USA |
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Abstract: | Encapsulating 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. |
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