SP455
ENCAPSULATING PERITONEAL SCLEROSIS − A SINGLE−CENTRE EXPERIENCE WITH 24 CASES

Introduction and Aims: Encapsulating peritoneal sclerosis (EPS) is a life threatening complication of peritoneal dialysis (PD) treatment. This is a rare form of a progressive inflammatory process that results in thickening and constricting of peritoneal membrane, thereby compromising the bowel motility and function. We investigated EPS incidence, clinical manifestations, treatment and outcome during the past 30 years in our peritoneal dialysis center.

Methods: A total of 620 patients were treated in our PD center, among which 24 patients were diagnosed with EPS 58% of whom were male.

Results: Incidence of EPS in our PD center during the observed period was 4%. Patients were diagnosed with EPS at the age of 50,8 ± 3,3 years. They were treated with PD for an average of 113,1 ± 7,6 months prior to diagnosis, and had a an average of 2,1 ± 0,3 peritonitis. Eight patients (33%) were initially treated with hemodialysis and were switched to PD after 6,6 ± 1,7 years. EPS treatment modalities included surgery and immunosuppression. Twenty-one of our patients received immunosuppressive therapy (table 1), 9 for treatment of EPS, and 12 as part of the maintenance immunosuppressive protocol while they developed EPS after renal transplantation. Eight also underwent adhesiolysis, and 4 of these patients are still alive and active. Ten patients died (mortality rate 42%), 22±7 months after the diagnosis of EPS. All patients who developed EPS after renal transplantation are still alive. Conclusions: This case series shows important data that support the current knowledge on EPS being a very serious and life threatening complication of PD treatment. According to our results, patients who develop EPS after renal transplantation have better survival. Possibility that more intensive immunosuppressive therapy improves survival needs further investigations.