Document Detail


The peritoneal osmotic conductance is low well before the diagnosis of encapsulating peritoneal sclerosis is made.
MedLine Citation:
PMID:  20571473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Encapsulating peritoneal sclerosis (EPS) is a serious condition whose frequency is increasing the longer the duration of peritoneal dialysis. To identify prognostic indicators of EPS, we studied here longitudinal changes in peritoneal membrane function of patients who later developed this complication. We identified all patients with an unequivocal diagnosis of EPS who began their peritoneal dialysis in our unit over a 20-year period and matched each of them for dialysis duration and age with four control patients who completed their dialysis. The dialysate/plasma creatinine ratio increased with time in both groups but was significantly higher in the patients with EPS only at the time their dialysis was discontinued. The ultrafiltration capacity was significantly worse for at least 2 years before stopping dialysis, diverging further at the time dialysis ceased, suggesting reduced osmotic conductance in the EPS patients. Both the glucose exposure rate for the 5 years preceding stoppage of dialysis and exposure to the osmotic agent icodextrin were significantly higher. Residual renal function was less in the EPS group, but there was no significant difference in the rates of peritonitis compared to the control group. The 24 h peritoneal protein clearance was not significantly different in EPS patients, possibly due to a greater fibrous matrix. Thus, our study shows that regular peritoneal membrane function tests can identify most patients at high risk of developing EPS before its occurrence.
Authors:
Mark L Lambie; Biju John; Lily Mushahar; Christopher Huckvale; Simon J Davies
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Publication Detail:
Type:  Journal Article     Date:  2010-06-23
Journal Detail:
Title:  Kidney international     Volume:  78     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  611-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology, University Hospital of North Staffordshire, Stoke on Trent, UK.
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Dialysis Solutions
Early Diagnosis*
Female
Glucans / pharmacology
Glucose / pharmacology
Humans
Male
Middle Aged
Osmosis*
Peritoneal Dialysis / adverse effects*
Peritoneal Fibrosis / diagnosis*
Peritoneum / physiopathology
Peritonitis
Chemical
Reg. No./Substance:
0/Dialysis Solutions; 0/Glucans; 0/icodextrin; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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