TY - JOUR
T1 - Absence of post-transplantation encapsulating peritoneal sclerosis after relatively short exposure to peritoneal dialysis
T2 - Prospective analysis using repeated abdominal ct scanning
AU - Abrahams, Alferso C.
AU - Van Gelder, Maaike K.
AU - van der Veer, Jan Willem
AU - De Jong, Pim A.
AU - van Leeuwen, MS
AU - Boer, Walther H.
N1 - Funding Information:
This study was financially supported by a Clinical Evidence Council (CEC) grant from Baxter Healthcare Corporation (Grant #08CEC2EU004). The funder of this study had no role in study design, data collection, data analysis, data interpretation, decision to publish, or writing of the manuscript. ACA has received speaker fees from Baxter Healthcare and Fresenius Medical Care. WHB has received speaker fees from Baxter Healthcare. The other authors declared no competing interests.
Publisher Copyright:
© 2017 International Society for Peritoneal Dialysis.
PY - 2017
Y1 - 2017
N2 - ♦♦ Background: Encapsulating peritoneal sclerosis (EPS) is the most severe complication of peritoneal dialysis (PD). Several retrospective reports published between 2007 and 2009 have suggested an increasing incidence of EPS occurring after kidney transplantation. We conducted a prospective observational study to determine the incidence of post-transplantation EPS and identify possible risk factors. ♦♦Methods: Consecutive PD patients undergoing kidney transplantation between 2009 and 2013 were included. Encapsulating peritoneal sclerosis was defined as gastrointestinal obstruction combined with radiological evidence of EPS. Gastrointestinal symptoms were assessed using a self-administered Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Abdominal computed tomography (CT) was performed prospectively at 6 and 18 months post-transplantation. The primary end point was EPS during follow-up. ♦♦ Results: Fifty-three PD patients were included (age 51 ± 14 years). Mean PD duration was 31.3 months. Peritoneal dialysis solutions low in glucose degradation products and icodextrin were used by 86.8% of patients. A fast or average-fast transport status was documented in 83.0%. After a median follow-up of 19 months, complete data of 47 patients were available for analysis. None of the patients developed clinical or radiological signs of EPS. The GSRS score improved from 1.87 to 1.55 (p = 0.024) and body weight increased from 75.9 to 78.3 kg (p = 0.003). Only 1 patient had new onset localized (< 20%) peritoneal thickening on CT 22 months post-transplantation. ♦♦ Conclusion: Post-transplantation EPS did not develop in this cohort of patients with a relatively short time of PD exposure. This suggests that these patients can be transplanted safely without concern for the development of EPS, at least within the follow-up period of 19 months.
AB - ♦♦ Background: Encapsulating peritoneal sclerosis (EPS) is the most severe complication of peritoneal dialysis (PD). Several retrospective reports published between 2007 and 2009 have suggested an increasing incidence of EPS occurring after kidney transplantation. We conducted a prospective observational study to determine the incidence of post-transplantation EPS and identify possible risk factors. ♦♦Methods: Consecutive PD patients undergoing kidney transplantation between 2009 and 2013 were included. Encapsulating peritoneal sclerosis was defined as gastrointestinal obstruction combined with radiological evidence of EPS. Gastrointestinal symptoms were assessed using a self-administered Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Abdominal computed tomography (CT) was performed prospectively at 6 and 18 months post-transplantation. The primary end point was EPS during follow-up. ♦♦ Results: Fifty-three PD patients were included (age 51 ± 14 years). Mean PD duration was 31.3 months. Peritoneal dialysis solutions low in glucose degradation products and icodextrin were used by 86.8% of patients. A fast or average-fast transport status was documented in 83.0%. After a median follow-up of 19 months, complete data of 47 patients were available for analysis. None of the patients developed clinical or radiological signs of EPS. The GSRS score improved from 1.87 to 1.55 (p = 0.024) and body weight increased from 75.9 to 78.3 kg (p = 0.003). Only 1 patient had new onset localized (< 20%) peritoneal thickening on CT 22 months post-transplantation. ♦♦ Conclusion: Post-transplantation EPS did not develop in this cohort of patients with a relatively short time of PD exposure. This suggests that these patients can be transplanted safely without concern for the development of EPS, at least within the follow-up period of 19 months.
KW - Abdominal CT scan
KW - Encapsulating peritoneal sclerosis
KW - Gastrointestinal symptom rating scale
KW - Kidney transplantation
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=85028509931&partnerID=8YFLogxK
U2 - 10.3747/pdi.2016.00238
DO - 10.3747/pdi.2016.00238
M3 - Article
C2 - 28676511
AN - SCOPUS:85028509931
SN - 0896-8608
VL - 37
SP - 443
EP - 450
JO - Peritoneal Dialysis International
JF - Peritoneal Dialysis International
IS - 4
ER -