Sclerosing encapsulating peritonitis in pediatric peritoneal dialysis patients

• Published in: Pediatric nephrology (Berlin, West) West), 2000-04, Vol.14 (4), p.275-279
• Main Authors: HOSHII, S, HONDA, M, ITAMI, N, OH, S, MATSUMURA, C, MORIYA, S, MORI, M, HATAE, K, ITO, Y, KARASHIMA, S
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Ascites; Biological and medical sciences; Calcification; Candidiasis; Emergency and intensive care: renal failure. Dialysis management; Enterococcus; Gram-Positive Bacterial Infections; Hemodialysis; Humans; Intensive care medicine; Medical sciences; Medicine; Mortality; Patients; Pediatrics; Peritoneal dialysis; Peritoneal Dialysis - adverse effects; Peritoneum - pathology; Peritonitis; Peritonitis - diagnosis; Peritonitis - etiology; Peritonitis - microbiology; Peritonitis - pathology; Questionnaires; Sclerosis; Staphylococcal Infections; Transplants & implants
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s004670050758

The aim of this study was to define the incidence and characteristics of sclerosing encapsulating peritonitis (SEP) in pediatric peritoneal dialysis (PD) patients in Japan. A questionnaire was sent to all dialysis units with at least two pediatric PD patients. Among 687 patients registered, 11 cases (1.6%) of SEP were diagnosed. The mean age of patients with SEP at the start of PD was 9.7+/-3.6 years and at SEP diagnosis, 19.1+/-3.8 years. All patients had undergone PD for more than 5 years, and the mean PD duration was 9.6+/-3.3 years. SEP was diagnosed in 6.6% and 12% of patients dialyzed for >5 years and >8 years, respectively. The incidence of peritonitis among patients with SEP was not different from that among the Japanese pediatric registry. All patients had virtually no residual urine volume and 9 had impaired peritoneal ultrafiltration. Peritoneal calcification was the most-frequent radiological finding. Peritoneal biopsy was performed in 7 patients and confirmed sclerotic peritonitis in all. Ten patients transferred to hemodialysis, and only 1 patient underwent surgery. Three patients died. We recommend that patients on PD for more than 5 years who have impaired peritoneal ultrafiltration or peritoneal calcification should be carefully managed as presumptive cases of SEP.