Department of Nephrology, Evangelismos General Hospital, Athens, Greece.
Ren Fail. 2011;33(2):246-8. doi: 10.3109/0886022X.2011.552147.
Sclerosing peritonitis (SP) is a rare but serious complication of peritoneal dialysis (PD), characterized by a fibrous peritoneal thickening. The etiology of this condition remains unknown but is likely to be multifactorial. Patients with SP almost invariably develop ultrafiltration and clearance failure. Although a number of pharmacologic drug treatment options have been tried with various results, surgical treatment and cessation of PD are almost always necessary and transfer to hemodialysis is the only practical option. Despite some evidence supporting the recovery of gastrointestinal function after renal transplantation in such patients, SP may very rarely appear much later after the cessation of PD and even after renal transplantation. We report an interesting case of a former PD patient who 2 years after renal transplantation presented with abdominal discomfort, vomiting, and malnutrition due to SP. Despite the initial conservative treatment, the symptoms persisted and a surgical treatment was decided upon. After that the patient recovered with no further complications. Although the appearance of SP after renal transplantation is extremely rare, it must be included in the differential diagnosis of every case of unexplained malnutrition and abdominal obstruction in a patient with a PD history.
硬化性腹膜炎（SP）是腹膜透析（PD）的一种罕见但严重的并发症，其特征为纤维性腹膜增厚。这种情况的病因尚不清楚，但可能是多因素的。患有 SP 的患者几乎无一例外地出现超滤和清除失败。尽管已经尝试了许多药物治疗选择，但结果各不相同，手术治疗和停止 PD 几乎总是必要的，并且转至血液透析是唯一可行的选择。尽管有一些证据支持在这种患者中肾脏移植后胃肠道功能恢复，但 SP 可能在 PD 停止后甚至在肾脏移植后很久才会非常罕见地出现。我们报告了一例有趣的病例，一名前 PD 患者在肾脏移植后 2 年因 SP 出现腹部不适、呕吐和营养不良。尽管最初进行了保守治疗，但症状仍持续存在，决定进行手术治疗。此后，患者康复，无进一步并发症。尽管 SP 在肾脏移植后出现的情况极为罕见，但对于有 PD 病史的患者出现不明原因的营养不良和腹部梗阻的每个病例，都必须将其纳入鉴别诊断。
