Department of Internal Medicine, Division of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Nephrol Dial Transplant. 2011 Jan;26(1):291-8. doi: 10.1093/ndt/gfq343. Epub 2010 Jun 21.
Encapsulating peritoneal sclerosis (EPS) is a severe complication of peritoneal dialysis (PD). The first aim was to analyse the risk of EPS in patients who had developed ultrafiltration failure (UFF). The second aim was to identify specific peritoneal transport alterations that distinguish patients with UFF from patients who will develop EPS.
All patients of this study were treated with PD between July 1995 and December 2008 in the Academic Medical Center, Amsterdam, the Netherlands. Risk analysis: all PD patients who developed UFF after at least 2 years of PD. Peritoneal transport analysis: all patients who had PD for at least 55 months were included: 12 EPS patients, 21 patients with UFF and 26 patients with normal ultrafiltration (UF). The peritoneal function was measured yearly with a standard peritoneal permeability analysis. UFF was defined as net UF < 400 mL after a 4-h dwell with a 3.86% dialysis solution.
Risk analysis: Of the 48 UFF patients, 10 eventually developed EPS. Fifty percent of the patients who continued PD for more than 3 years after the establishment of UFF developed EPS. Peritoneal function analysis: No differences were present for the time courses of solute transport and fluid transport between the EPS and the UFF groups. Overall, the EPS and normal UF groups had lower values for the effective lymphatic absorption rate (ELAR) than the UFF group.
The risk of EPS increases with continuation of PD while UFF is present. Transport characteristics are similar between EPS patients and UFF patients without this complication. A constantly low ELAR may distinguish the EPS patients from those with UFF only.
包裹性腹膜硬化症（EPS）是腹膜透析（PD）的严重并发症。本研究的首要目的是分析超滤衰竭（UFF）患者发生 EPS 的风险。第二个目的是确定区分 UFF 患者和将发生 EPS 患者的特定腹膜转运改变。
本研究所有患者均于 1995 年 7 月至 2008 年 12 月在荷兰阿姆斯特丹学术医学中心接受 PD 治疗。风险分析：所有至少接受 2 年 PD 治疗后发生 UFF 的 PD 患者。腹膜转运分析：纳入所有至少接受 55 个月 PD 治疗的患者：12 例 EPS 患者、21 例 UFF 患者和 26 例超滤正常（UF）患者。每年使用标准腹膜通透性分析测量腹膜功能。UFF 定义为在 3.86%透析液中留置 4 小时后净超滤<400ml。
风险分析：48 例 UFF 患者中，10 例最终发展为 EPS。50%在 UFF 发生后继续 PD 治疗超过 3 年的患者发生 EPS。腹膜功能分析：在溶质转运和液体转运的时间过程中，EPS 组和 UFF 组之间没有差异。总体而言，EPS 组和 UF 组的有效淋巴吸收率（ELAR）值低于 UFF 组。
当 UFF 存在时，继续进行 PD 治疗会增加发生 EPS 的风险。转运特征在 EPS 患者和无此并发症的 UFF 患者之间相似。持续较低的 ELAR 可能将 EPS 患者与仅发生 UFF 的患者区分开来。
