High-transport membrane is a risk factor for encapsulating peritoneal sclerosis developing after long-term continuous ambulatory peritoneal dialysis treatment

Abstract

Increased peritoneal function has been suggested to be a risk factor for developing encapsulating peritoneal sclerosis (EPS); however, clinical evidence is scarce. The present study aimed to clarify the specific character of peritoneal function in patients who developed EPS after withdrawal from peritoneal dialysis (PD). We studied 12 patients who developed EPS after PD withdrawal [(EPS group) mean PD duration: 109 months; mean period of EPS development: 7.0 months after withdrawal] and 128 patients who did not develop EPS (non EPS group). All 140 patients were withdrawn from continuous ambulatory peritoneal dialysis (CAPD) and were observed for the following 24 months. Based on the records of the annual peritoneal equilibration tests (PETs), we analyzed (1) the patients' dialysate-to-plasma (D/P) creatinine at various durations on PD, and (2) the accumulative appearance incidence of high-transport (HT) state of peritoneal membrane. The mean D/P creatinine in EPS group was significantly higher than that in the non EPS group in the course of PD from the 6th to the 10th year. The accumulative incidence of HT was significantly higher in the EPS group than in the non EPS group, indicating early development of HT membrane in EPS group. Early development of increased D/P creatinine, classified as HT state, was observed during certain periods on PD in patients who developed EPS after PD withdrawal. That finding may indicate that HT state of peritoneal membrane is an early marker for EPS, and that the PET is useful to detect patients at high risk of EPS.