Nephrology Dialysis Transplantation, Vol 13, Issue 1 154-159, Copyright © 1998 by Oxford University Press
R Rigby and C Hawley
Background: Sclerosing peritonitis (SP) is a rare but
serious complication of peritoneal dialysis (PD). Small-bowel obstruction
(SBO) due to encapsulation, dense adhesions, or mural fibrous is
characteristic, often associated with peritonitis. The aim of the study was
to determine the incidence, clinical features, effect of duration of
dialysis, and other possible aetiological factors in severe SP.
Methods: All dialysis units in Australia were surveyed
for possible cases up to 1994. Patients were included if there was either
surgical or radiological evidence of sclerosing encapsulating peritonitis
or SBO with tanned or thickened peritoneum in the absence of other causes
of SBO. Results: Fifty-four patients were analysed.
The duration of continuous PD was mean 52±30 months, median 48
months and range 8-27 months. Nineteen cases were diagnosed between 1980
and 1989 and 35 between 1990 and 1994, giving mean annual incidences 1.9
and 4.2 per 1000 PD periods respectively. The overall prevalence was 0.7%,
which increased progressively with the duration of PD being 1.9, 6.4, 10.8,
and 19.4% for patients on dialysis for >2, 5, 6 ad 8 years
respectively. Sclerosing encapsulating peritonitis was diagnosed in 87% of
cases. SBO in 92%, and haemoperitoneum in 8%. Peritoneal calcification was
present in seven cases, all of which had been on PD >7 years.
Peritonitis was associated with 38% of cases with fungal infection in 7%.
Treatment with immunosuppression in five patients appeared to result in a
favourable outcome in three. The mortality rate was 56%.
Conclusion: Severe sclerosing peritonitis is a serious
complication of peritoneal dialysis and there is a time dependent increase
on CAPD. Key words: peritoneal dialysis; sclerosing
peritonitis
ORIGINAL ARTICLES
Sclerosing peritonitis: the experience in Australia
Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia 4102; Corresponding author
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