Brown Michaela C, Simpson Keith, Kerssens Jan J, Mactier Robert A
Scottish Renal Registry, Royal Infirmary, Glasgow, UK.
Clin J Am Soc Nephrol. 2009 Jul;4(7):1222-9. doi: 10.2215/CJN.01260209. Epub 2009 Jun 18.
The study aim was to establish the incidence and characterize all encapsulating peritoneal sclerosis (EPS) cases in patients treated by peritoneal dialysis (PD).
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The patient cohort, which started PD from January 1, 2000, to December 31, 2007, was identified from the Scottish Renal Registry (n = 1238). Possible EPS cases were identified by the ten adult Scottish renal units. Patient records were examined to ensure cases met diagnostic criteria.
Forty-six cases were identified; 19 had their first PD exposure after January 1, 2000. The rate was 1.5%, an incidence of 4.9 per 1000 person-years. The incidence increased with PD duration, with rates of 0, 0.6, 2.0, 3.5, 8.1, 8.8 and 5% at <1, 1 to 2, >2 to 3, >3 to 4, >4 to 5, >5 to 6 and >6 yr PD exposure, respectively. The median PD duration of EPS cases was 5.1 yr (interquartile range [IQR] 3.4 to 6.1 yr). At diagnosis, 12 (26%) were on PD and 33 (72%) were diagnosed <2 yr after PD stopped. The cases had a median of 3.3 episodes of peritonitis (range 0 to 20, IQR 1 to 4.5). Thirty (65%) had used 3.86% dextrose dialysate and 45 (98%) had used Extraneal. The mortality was 42% at 1 yr postdiagnosis with a median survival of 149 d (IQR 61 to 408 d).
The incidence reported in this study may be used to inform patients of the minimum risk of developing EPS on PD.
本研究旨在确定接受腹膜透析（PD）治疗的患者中所有包裹性腹膜硬化（EPS）病例的发生率并对其特征进行描述。
设计、地点、参与者与测量方法：从苏格兰肾脏登记处（n = 1238）中确定了于2000年1月1日至2007年12月31日开始进行PD治疗的患者队列。由十个苏格兰成人肾脏科室确定可能的EPS病例。检查患者记录以确保病例符合诊断标准。
共确定了46例病例；其中19例在2000年1月1日之后首次接受PD治疗。发生率为1.5%，即每1000人年4.9例。发生率随PD治疗时间的延长而增加，腹膜透析暴露时间<1年、1至2年、>2至3年、>3至4年、>4至5年、>5至6年和>6年时的发生率分别为0、0.6%、2.0%、3.5%、8.1%、8.8%和5%。EPS病例的PD治疗时间中位数为5.1年（四分位间距[IQR]为3.4至6.1年）。诊断时，12例（26%）正在进行PD治疗，33例（72%）在PD治疗停止后<2年被诊断出。这些病例腹膜炎发作的中位数为3.3次（范围为0至20次，IQR为1至4.5次）。30例（65%）使用过3.86%葡萄糖透析液，45例（98%）使用过艾考糊剂。诊断后1年的死亡率为42%，中位生存期为149天（IQR为61至408天）。
本研究报告的发生率可用于告知患者接受PD治疗时发生EPS的最低风险。
