Braun Niko, Alscher Mark Dominik, Kimmel Martin, Amann Kerstin, Büttner Maike
Zentrum für Innere Medizin IV, Abteilung für Allgemeine Innere Medizin und, Nephrologie, Robert-Bosch Krankenhaus, Auerbachstrasse, Stuttgart, Germany.
Nephrol Ther. 2011 Jun;7(3):162-71. doi: 10.1016/j.nephro.2010.12.011. Epub 2011 Mar 31.
Encapsulating peritoneal sclerosis (EPS) is a rare but life-threatening complication of peritoneal sclerosis (PD). In 2000, the International Society for Peritoneal Dialysis outlined diagnostic guidelines and a clinical definition of EPS. Over the intervening years, new evidence was published and several centers became more experienced managing patients with EPS. Although, further networking was initiated (European EPS Working Group), evidence regarding therapy and diagnosis of EPS is still lacking. Multicenter trials are needed to establish evidence regarding the management of EPS. Risk factors for EPS are identified and patients at risk should be monitored closely. In case of emerging signs of EPS, patients should be referred to an EPS-center before initiation of therapy. Morphology and immunohistochemistry will play a central role in the near future. Nowadays, most pathologists are not sophisticated in the pathology of peritoneal biopsies. Clear histological criteria are warranted. For the outcome of the patient, it is crucial that an EPS experienced surgeon conducts surgery.
包裹性腹膜硬化（EPS）是腹膜透析（PD）一种罕见但危及生命的并发症。2000年，国际腹膜透析学会概述了EPS的诊断指南和临床定义。在随后的几年里，有新的证据发表，一些中心在管理EPS患者方面也积累了更多经验。尽管已经启动了进一步的合作网络（欧洲EPS工作组），但关于EPS治疗和诊断的证据仍然不足。需要进行多中心试验来确立有关EPS管理的证据。EPS的危险因素已被识别，应对有风险的患者进行密切监测。如果出现EPS的迹象，患者应在开始治疗前转诊至EPS中心。形态学和免疫组织化学在不久的将来将发挥核心作用。目前，大多数病理学家对腹膜活检的病理学并不精通。明确的组织学标准是必要的。对于患者的预后而言，由有EPS治疗经验的外科医生进行手术至关重要。
