Nakao Masatsugu, Yokoyama Keitaro, Yamamoto Izumi, Matsuo Nanae, Tanno Yudo, Ohkido Ichiro, Hayakawa Hiroshi, Ikeda Masato, Yamamoto Hiroyasu, Hosoya Tatsuo
Department of Internal Medicine, Division of Kidney and Hypertension, The Jikei University School of Medicine, Tokyo, Japan.
Ther Apher Dial. 2014 Feb;18(1):68-73. doi: 10.1111/1744-9987.12048. Epub 2013 Apr 17.
Encapsulating peritoneal sclerosis (EPS) is a serious complication that occurs in patients with long-term peritoneal dialysis (PD). Investigation of risk factors that contribute to EPS in patients on long-term PD therapy is needed. In a retrospective, observational study, data were collected for 107 patients treated with PD therapy for more than 5 years. Fifty cases of EPS were compared with 57 cases of non-EPS. To evaluate the impact of PD-associated peritonitis in EPS, univariate and multivariate logistic regression models were applied. Episodes of peritonitis, number of peritonitis episodes and the duration of peritonitis were included as explanatory variables in addition to previously reported risk factors. D/P Cr and serum β2MG levels in the EPS and non-EPS groups were: 0.82 ± 0.10 and 0.67 ± 0.12 (P < 0.01), and 33.8 ± 8.54 and 29.2 ± 8.18 mg/L (P < 0.01), respectively. Episodes of peritonitis, number of peritonitis episodes and the duration of peritonitis was 68% and 42% (P < 0.01), 1.80 ± 2.19 and 0.75 ± 1.07 times (P < 0.01), and 18.1 ± 15.3 and 10.2 ± 4.90 days (P < 0.01), in the EPS and non-EPS groups, respectively. Furthermore, multivariate logistic regression models demonstrated that both D/P Cr and the duration of peritonitis were independently associated with EPS (P < 0.01 and P < 0.05, respectively). In patients on long-term PD therapy, D/P Cr and the duration of peritonitis are independently associated with EPS. Earlier treatment to promote an early recovery from PD-associated peritonitis could be critical in preventing EPS.
包裹性腹膜硬化（EPS）是长期腹膜透析（PD）患者发生的一种严重并发症。需要对长期接受PD治疗的患者中导致EPS的危险因素进行研究。在一项回顾性观察研究中，收集了107例接受PD治疗超过5年的患者的数据。将50例EPS患者与57例非EPS患者进行比较。为评估PD相关性腹膜炎对EPS的影响，应用了单因素和多因素逻辑回归模型。除先前报道的危险因素外，腹膜炎发作次数、腹膜炎发作的次数和腹膜炎持续时间作为解释变量纳入。EPS组和非EPS组的D/P Cr和血清β2MG水平分别为：0.82±0.10和0.67±0.12（P<0.01），以及33.8±8.54和29.2±8.18mg/L（P<0.01）。EPS组和非EPS组的腹膜炎发作次数、腹膜炎发作的次数和腹膜炎持续时间分别为68%和42%（P<0.01），1.80±2.19和0.75±1.07次（P<0.01），以及18.1±15.3和10.2±4.90天（P<0.01）。此外，多因素逻辑回归模型显示，D/P Cr和腹膜炎持续时间均与EPS独立相关（分别为P<0.01和P<0.05）。在长期接受PD治疗的患者中，D/P Cr和腹膜炎持续时间与EPS独立相关。促进PD相关性腹膜炎早期恢复的早期治疗对于预防EPS可能至关重要。
