Farnaz Tavakoli
1, Fatemeh Yaghoubi
1, Davood Babakhani
2, Farnoosh Tavakoli
3*1 Nephrology and Kidney Transplantation Ward, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Hematology, Oncology Research Center and Stem Cell Transplantation (HORCSCT), Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Patients suffering from chronic peritoneal dialysis (PD) encapsulating
peritoneal sclerosis (EPS) are more likely to have a small bowel obstruction, sepsis, and death.
Objectives: This study was conducted to investigate how the EPS is prevalent in Iranian
patients suffering from continuous chronic PD. It was also tried to detect risk factors, clinical
symptoms, signs, complications and mortality rate.
Patients and Methods: The study population consisted of all incident patients undergoing PD
for more than 6 months from 1994 until 2015. The criterion to detect EPS was either positive
radiological or surgical results in terms of the clinical short bowel obstruction (SBO) or a
thickened peritoneum in the absence of an alternative etiology. Control groups were non-EPS
patients that were twice the EPS patients. These patients were being followed up for at least 6
months after the end of PD.
Results: This study showed that in people with EPS, 58.3% were women. The mean age was 47
years. The duration of treatment with PD in these patients was 58 months. Mortality rate in
patients with EPS was 61.1 percent.
Conclusion: It is advisable that individuals should be treated with chronic PD for a maximum
period of three to 4 years.
Implication for health policy/practice/research/medical education:
Encapsulating peritoneal sclerosis (EPS) is a grave and life-threatening side effect of peritoneal dialysis (PD). The early
clinical symptoms and signs are directly associated with disturbances in gastrointestinal transit. The most common findings
are abdominal pain, nausea, vomiting, anorexia, abdominal mass and significant protein loss that leads to malnutrition, and
incomplete or complete small-bowel obstruction. Though the observed findings may be powerfully indicative of EPS, radiologic
examination is required to confirm a clinical diagnosis of EPS. Not infrequently, laparotomy or laparoscopy is required to
establish the diagnosis. The main elements in conservative management are early diagnosis, cessation of PD with transfer to
hemodialysis, continued bowel rest with total parenteral nutrition, and corticosteroids. If conservative treatment does not
ameliorate the symptoms of EPS, surgical treatment should be envisaged. By definition, EPS refers merely to the encapsulating
and ileus stages of the disease. However, the early identification should be recognized before the symptoms of ileus occur. Hence,
an effort to cure the illness with medical treatment can be conducted. Further studies concerning prevention, early detection,
and treatment of EPS are also necessary.
Please cite this paper as: Tavakoli F, Yaghoubi F, Babakhani D, Tavakoli F. Determination of prevalence, symptoms, signs,
complications and mortality rate in patients with encapsulating peritoneal sclerosis in Iran. J Renal Inj Prev. 2019;8(1):17-21.
DOI: 10.15171/jrip.2019.04.