TY - JOUR
T1 - Prognosis of patients on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years
AU - Toyohara, Takafumi
AU - Ubara, Yoshifumi
AU - Higa, Yasushi
AU - Suwabe, Tatsuya
AU - Hoshino, Junichi
AU - Sumida, Keiichi
AU - Hiramatsu, Rikako
AU - Nagasawa, Motonori
AU - Hasegawa, Eiko
AU - Yamanouchi, Masayuki
AU - Hayami, Noriko
AU - Marui, Yuji
AU - Sawa, Naoki
AU - Nakamura, Michio
AU - Tomikawa, Shinji
AU - Takaichi, Kenmei
PY - 2011
Y1 - 2011
N2 - Background Patients who have been on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years are known to have a risk of developing encapsulating peritoneal sclerosis (EPS). However, the prognosis of patients on CAPD for over 10 years remains unclear. Methods To better understand the efficacy of a variety of treatments for EPS, we retrospectively reviewed 25 patients who started CAPD at Toranomon Hospital from 1981 to 1997 and continued it for longer than 10 years. Results The CAPD catheter was removed without peritoneal lavage in the initial 3 patients and they developed massive ascites. They all died of infection without resolution of the ascites. Accordingly, in the remaining 13 patients who did not undergo kidney transplantation, peritoneal lavage therapy was performed for 12 months before removing the CAPD catheter. As a result, 4 patients did not develop EPS. However, 9 patients had EPS with ascites, among whom 4 died of EPS-related diseases and 5 are alive. Five patients underwent cadaveric donor kidney transplantation. At the time of surgery, the CAPD catheter was removed without peritoneal lavage; 1 patient suffered from massive ascites immediately, although this subsided within 3 months after kidney transplantation, and 4 patients remain free from EPS-related symptoms and are doing well. Conclusion Kidney transplantation may be an option for preventing EPS. This study showed that improvement of the uremic state as well as treatment with immunosuppressants including corticosteroids may contribute to preventing EPS.
AB - Background Patients who have been on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years are known to have a risk of developing encapsulating peritoneal sclerosis (EPS). However, the prognosis of patients on CAPD for over 10 years remains unclear. Methods To better understand the efficacy of a variety of treatments for EPS, we retrospectively reviewed 25 patients who started CAPD at Toranomon Hospital from 1981 to 1997 and continued it for longer than 10 years. Results The CAPD catheter was removed without peritoneal lavage in the initial 3 patients and they developed massive ascites. They all died of infection without resolution of the ascites. Accordingly, in the remaining 13 patients who did not undergo kidney transplantation, peritoneal lavage therapy was performed for 12 months before removing the CAPD catheter. As a result, 4 patients did not develop EPS. However, 9 patients had EPS with ascites, among whom 4 died of EPS-related diseases and 5 are alive. Five patients underwent cadaveric donor kidney transplantation. At the time of surgery, the CAPD catheter was removed without peritoneal lavage; 1 patient suffered from massive ascites immediately, although this subsided within 3 months after kidney transplantation, and 4 patients remain free from EPS-related symptoms and are doing well. Conclusion Kidney transplantation may be an option for preventing EPS. This study showed that improvement of the uremic state as well as treatment with immunosuppressants including corticosteroids may contribute to preventing EPS.
KW - Ascites
KW - CAPD
KW - Corticosteroid
KW - Encapsulating peritoneal sclerosis
KW - Kidney transplantation
KW - Peritoneal lavage therapy
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U2 - 10.2169/internalmedicine.50.5810
DO - 10.2169/internalmedicine.50.5810
M3 - Review article
C2 - 22041351
AN - SCOPUS:80455129379
VL - 50
SP - 2519
EP - 2523
JO - Internal Medicine
JF - Internal Medicine
SN - 0918-2918
IS - 21
ER -