Prognosis of patients on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years

Takafumi Toyohara, Yoshifumi Ubara, Yasushi Higa, Tatsuya Suwabe, Junichi Hoshino, Keiichi Sumida, Rikako Hiramatsu, Motonori Nagasawa, Eiko Hasegawa, Masayuki Yamanouchi, Noriko Hayami, Yuji Marui, Naoki Sawa, Michio Nakamura, Shinji Tomikawa, Kenmei Takaichi

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2519-2523
Number of pages5
JournalInternal Medicine
Volume50
Issue number21
DOIs
Publication statusPublished - 2011

Keywords

  • Ascites
  • CAPD
  • Corticosteroid
  • Encapsulating peritoneal sclerosis
  • Kidney transplantation
  • Peritoneal lavage therapy

ASJC Scopus subject areas

  • Internal Medicine

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