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The number of patients with severe encapsulating peritoneal sclerosis is decreasing in a large referral center in Germany

Authors Kitterer D, Braun N, Alscher MD, Segerer S, Latus J

Received 29 March 2016

Accepted for publication 6 May 2016

Published 5 August 2016 Volume 2016:9 Pages 183—186

DOI https://doi.org/10.2147/IJNRD.S108529

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Pravin Singhal


Daniel Kitterer,1 Niko Braun,2 M Dominik Alscher,1 Stephan Segerer,3,* Joerg Latus1,*

1Division of General Medicine and Nephrology, Department of Internal Medicine, Robert-Bosch-Hospital, Stuttgart, Germany; 2Nephrology Center Stuttgart, Stuttgart, Germany, 3Division of Nephrology, University Hospital, Zurich, Switzerland

*These authors contributed equally to this work

Background:
Encapsulating peritoneal sclerosis (EPS) is the most severe complication ­associated with long-term peritoneal dialysis (PD). Previous studies noticed a sharp decline in new patients with severe EPS. We investigated the number of severe EPS patients in our large referral center over almost 20 years.
Methods: All late-stage EPS patients who underwent major surgery due to extensive symptoms caused by bowel obstruction (vomiting, abdominal pain, and weight loss) between March 1997 and end of December 2015 in our hospital were included in the present study. An index was calculated between the number of patients with severe EPS and the implanted PD catheters in our center.
Results: Between 1979 and 2015, a total of 745 PD catheters were implanted in our center, with a steady increase in the numbers between 2003 and 2015. First patient with severe EPS was treated in 1998, then a rise in the number of patients with EPS was present in 2005. The number of patients with EPS peaked in the period of 2010–2012 (15 patients within 3 years). Afterward, both the absolute numbers and the index between the number of patients with severe EPS and the implanted catheters demonstrated a prominent reduction in the next 3-year period from 2013 to 2015.
Conclusion: Our data support the hypothesis that there seems to be a decrease of late-stage EPS incidence over the last years, but data about milder or asymptomatic patients are lacking. This should be kept in mind while giving the patients information about different renal replacement therapies at start of dialysis.

Keywords: encapsulating peritoneal sclerosis, EPS surgery, decrease of EPS incidence

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