Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia.
Kidney Int. 2010 May;77(10):904-12. doi: 10.1038/ki.2010.16. Epub 2010 Mar 10.
Encapsulating peritoneal sclerosis is a complication of peritoneal dialysis characterized by persistent, intermittent, or recurrent adhesive bowel obstruction. Here we examined the incidence, predictors, and outcomes of encapsulating peritoneal sclerosis (peritoneal fibrosis) by multivariate logistic regression in incident peritoneal dialysis patients in Australia and New Zealand. Matched case-control analysis compared the survival of patients with controls equivalent for age, gender, diabetes, and time on peritoneal dialysis. Of 7618 patients measured over a 13-year period, encapsulating peritoneal sclerosis was diagnosed in 33, giving an incidence rate of 1.8/1000 patient-years. The respective cumulative incidences of peritoneal sclerosis at 3, 5, and 8 years were 0.3, 0.8, and 3.9%. This condition was independently predicted by younger age and the duration of peritoneal dialysis, but not the rate of peritonitis. Twenty-six patients were diagnosed while still on peritoneal dialysis. Median survival following diagnosis was 4 years and not statistically different from that of 132 matched controls. Of the 18 patients who died, only 7 were attributed directly to peritoneal sclerosis. Our study shows that encapsulating peritoneal sclerosis is a rare condition, predicted by younger age and the duration of peritoneal dialysis. The risk of death is relatively low and not appreciably different from that of competing risks for mortality in matched dialysis control patients.
包裹性腹膜硬化症是腹膜透析的一种并发症，其特征为持续性、间歇性或复发性粘连性肠梗阻。在此，我们通过多变量逻辑回归分析了澳大利亚和新西兰新进入腹膜透析患者包裹性腹膜硬化症（腹膜纤维化）的发生率、预测因素和结果。匹配病例对照分析比较了包裹性腹膜硬化症患者和在年龄、性别、糖尿病和腹膜透析时间方面相匹配的对照组患者的生存率。在 13 年的时间里，对 7618 名患者进行了测量，有 33 名患者被诊断为包裹性腹膜硬化症，发病率为 1.8/1000 患者年。在 3、5 和 8 年内腹膜硬化症的累积发生率分别为 0.3、0.8 和 3.9%。这种情况独立地受到年龄较小和腹膜透析时间的预测，但不受腹膜炎发生率的影响。26 名患者在仍接受腹膜透析时被诊断为包裹性腹膜硬化症。诊断后的中位生存时间为 4 年，与 132 名匹配对照组患者的生存时间无统计学差异。在 18 名死亡患者中，只有 7 人直接归因于腹膜硬化症。我们的研究表明，包裹性腹膜硬化症是一种罕见的疾病，由年龄较小和腹膜透析时间预测。死亡风险相对较低，与匹配的透析对照组患者的其他死亡风险相比无明显差异。
