Chien Chih-Ying, Tsai Ming-Tsun, Chen Jinn-Yang, Chuang Chiao-Lin, Tian Jiu-Yun, Tai Hsin-Ling, Lin Chih-Ching, Li Szu-Yuan
Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, 11217, Taiwan.
BMC Nephrol. 2025 Sep 1;26(1):509. doi: 10.1186/s12882-025-04111-5.
Encapsulating peritoneal sclerosis (EPS) can result in abdominal organ encasement, and bowel obstruction, and is associated with a high mortality rate. While various risk factors have been identified for the development of EPS, the factors influencing patient outcomes in EPS are less well-studied. This study aims to investigate the prognostic factors that affect the clinical course and survival of EPS patients.
In this retrospective study, we examined a cohort of 1406 peritoneal dialysis (PD) patients over an 18-year study period. Among them, 35 individuals were diagnosed with EPS. We collected data encompassing demographic characteristics, comorbidities, PD-related parameters, clinical symptoms, computed tomography scores, laboratory results, and treatment modalities. The survival analysis incorporated both univariate and multivariate Cox regression models, as well as the Kaplan-Meier method.
Patients with EPS exhibited a spectrum of clinical symptoms, with intestinal obstruction occurring in 88.6% and ultrafiltration failure in 42.9%. The five-year survival rate was 26.3%, and malnutrition and gastrointestinal infections contributed to three-fourths of the deaths. A notable finding was the one-month drop in albumin levels as a marker of ongoing malabsorption, demonstrating its predictive value for both overall (HR 2.01, p = 0.042) and EPS-related (HR 2.79, p = 0.017) mortality.
This study emphasizes the crucial role of monitoring the one-month albumin drop after EPS diagnosis, providing valuable insights for the improvement of clinical management and patient care.
包裹性腹膜硬化症（EPS）可导致腹部器官包裹、肠梗阻，且死亡率高。虽然已确定了EPS发生的各种风险因素，但对影响EPS患者预后的因素研究较少。本研究旨在调查影响EPS患者临床病程和生存的预后因素。
在这项回顾性研究中，我们在18年的研究期间检查了一组1406例腹膜透析（PD）患者。其中，35人被诊断为EPS。我们收集了包括人口统计学特征、合并症、PD相关参数、临床症状、计算机断层扫描评分、实验室检查结果和治疗方式的数据。生存分析采用单变量和多变量Cox回归模型以及Kaplan-Meier方法。
EPS患者表现出一系列临床症状，88.6%出现肠梗阻，42.9%出现超滤失败。五年生存率为26.3%，营养不良和胃肠道感染占死亡人数的四分之三。一个显著发现是，作为持续吸收不良标志物的白蛋白水平在一个月内下降，这表明其对总体（HR 2.01，p = 0.042）和EPS相关（HR 2.79，p = 0.017）死亡率均具有预测价值。
本研究强调了在EPS诊断后监测白蛋白水平一个月下降情况的关键作用，为改善临床管理和患者护理提供了有价值的见解。
