Encapsulating peritoneal sclerosis


Authors: L. Fantová 1,3;  R. Šafářová 1,2;  S. Vaňková 1,2
Authors‘ workplace: Dialyzační středisko EuroCare, Praha 4, vedoucí prim. MUDr. Světlana Vaňková 1;  3. lékařská fakulta UK, Praha 2;  Nefrologická ambulance Centromed a. s., Praha, ředitelka MUDr. Milana Dokulilová 3
Published in: Vnitř Lék 2007; 53(2): 164-168
Category: Review

Overview

Encapsulating peritoneal sclerosis (EPS) is a rare complication of perioneal dialysis characterized by an extensive peritoneal fibrosis and bowel obstruction. The opinion on etiopathogenesis is not unified. An important factor seems to be carrying out peritoneal dialysis itself and exposition of peritoneum to nonphysiological influences (the incidence increases with the length of treatment by peritoneal dialysis). There is also a certain individual perceptivity of patient which is apparently caused by different immunological response. The result of EPS are serious anatomical and functional changes of peritoneum which lead not only to the loss of transport function of peritoneum but also to bowel malfunction and serious malnutrition. Imaging methods (ultrasound, computer tomography) are very important in the diagnostics of EPS, confirmation of diagnosis is histological. No laboratory markers which would mark the development of EPS exist so far. The ways of treatment are diverse, various surgical operations (liberation of bowel loops, resection of peritoneum) are carried out, there is an effort to influence immunological process. The drug of choice remain corticosteroids, Tamoxifen is promising. However, EPS mortality is still very high, between 56-93 %. The illness often progresses even after peritoneal dialysis is finished. The paper summerizes the existing knowledge about EPS, its diagnosis ant therapy.

Key words:
peritoneal dialysis - peritoneal sclerosis - peritoneal solution - peritonitis - bowel obstruction - immunosupression


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Labels
Diabetology Endocrinology Internal medicine
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