A patient who is undergoing peritoneal dialysis is at increased risk of developing encapsulating peritoneal sclerosis (EPS). The presence of certain risk factors can identify a patient who should be monitored for clinical evidence of this syndrome.
Patient selection: chronic peritoneal dialysis
Risk factors for EPS:
(1) duration of peritoneal dialysis >= 8 years
(2) recurrent episodes of peritonitis
(3) dialysis solutions that are bioincompatible based on osmolarity or components
(4) use of chlorhexidine to clean components
(5) abdominal surgery
(6) ascites
(7) introduction of talc or other particular matter
(8) intra-abdominal hemorrhage
Long-term followup is necessary since the onset of EPS may occur after peritoneal dialysis has been discontinued for some time.
Differential diagnosis:
(1) intraperitoneal adhesions
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