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Review
. 2022 Mar 21;17(3):e0265584.
doi: 10.1371/journal.pone.0265584. eCollection 2022.

Risk factors for Encapsulating Peritoneal Sclerosis in patients undergoing peritoneal dialysis: A meta-analysis

Dashan Li  1 , Yuanyuan Li  1 , Hanxu Zeng  1 , Yonggui Wu  1
Affiliations
Review

Risk factors for Encapsulating Peritoneal Sclerosis in patients undergoing peritoneal dialysis: A meta-analysis

Dashan Li et al. PLoS One. .

Abstract

Purpose: Encapsulating Peritoneal Sclerosis (EPS) is the most serious complication of long-term peritoneal dialysis (PD), which considerably reduces the patient's quality of life, leading to patients discontinuing PD. Considering these negative effects, it is necessary to systematically review and determine the risk factors of EPS.

Methods: The PubMed, Embase, Web of Science, Cochrane Library, and China Biology Medicine (CBM) were searched from their inception to January 1st, 2022, and the bibliographies from the citations of relevant articles were manually searched. The ROBINS-I (Risk of Bias in Non-randomized studies of Interventions) tool was used to evaluate the risk of bias of included studies.

Results: Ten studies involving 12595 participants were included in this meta-analysis. The results revealed that a younger age at PD onset (MD = -7.70, 95% CI, -11.53~-3.86), a higher transporter (MD = 0.13, 95% CI, 0.09~0.18), a longer PD duration (SMD = 1.15, 95% CI, 0.68~1.61), a longer peritonitis duration (MD = 12.66, 95% CI, 3.85~21.47), and history of glomerulonephritis (OR = 1.42, 95% CI, 1.02~1.97) were significant risk factors for EPS. However, sex, use of icodextrin, the number of peritonitis episodes, and history of multicystic kidney disease did not affect the risk of EPS.

Conclusions: This review provides a scientific basis for further understanding the etiology of PD-related EPS and improving prevention strategies. More high-quality studies are necessary to validate this paper's findings.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of the literature selection in this meta-analysis.
Fig 2
Fig 2
A. Forest plot of age at PD onset and EPS in the exploratory meta-analysis. The mean difference and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. B. Forest plot of sex and EPS in the exploratory meta-analysis. The odds ratio and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. C. Forest plot of D/P Cr and EPS in the exploratory meta-analysis. The mean difference and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right.
Fig 3
Fig 3
A. Forest plot of PD duration and EPS in the exploratory meta-analysis. The standard mean difference and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. B. Forest plot of number of peritonitis episodes and EPS in the exploratory meta-analysis. The odds ratio and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. C. Forest plot of peritonitis duration and EPS in the exploratory meta-analysis. The mean difference and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right.
Fig 4
Fig 4
A. Forest plot of use of icodextrin and EPS in the exploratory meta-analysis. The odds ratio and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. B. Forest plot of GN and EPS in the exploratory meta-analysis. The odds ratio and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right. C. Forest plot of PKD and EPS in the exploratory meta-analysis. The odds ratio and 95% CI for each study and the final combined results are displayed numerically on the left and graphically as a forest plot on the right.
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