A Case of Sclerosing Peritonitis Successfully Treated with Corticosteroid Therapy / 대한신장학회잡지

Sclerosing peritonitis is a rare but fatal complication of peritoneal dialysis (PD). Management of sclerosing peritonitis includes cessation of PD, total parenteral nutrition, and surgery. Recently, a few reports have indicated immunosuppression might be beneficial in sclerosing peritonitis. In these reports, all of patients had the combination therapy of steroid and immunosuppressant. A 37-year old man develped sclerosing peritonitis 3 months after switching from PD to hemodialysis because of uncontrolled peritonitis. An abdominal computed tomography (CT) scan demonstrated massive ascites with multilocuated fluid collection and extensive enhancement of the peritoneum. A peritoneal biopsy showed proliferation of fibrous collagenous tissue with infiltration of lymphocytes. We started corticosteroid for one month. A follow-up CT scan showed complete resolution with absence of peritoneum thickness and fluid collection 16 months after corticosteroid therapy. The patient currently remains free of symptoms in an outpatient hemodialysis unit. To our knowledge, this is the first case of sclerosing peritonitis successfully treated with corticosteroid therapy alone in Korea.

Electrogastrography in Uremic Patients on Maintenance Hemodialysis with Dyspepsia / 대한소화관운동학회지

BACKGROUND/AIMS: The changes in an Electrogastrography (EGG) in uremic patients on maintenance hemodialysis with dyspeptic complaints are not well known. The aim of this study was to investigate the EGG findings in uremic patients with dyspeptic complaints and note the difference of EGG findings between uremic patients with dyspeptic complaints and patients with functional dyspepsia. METHODS: Fifty two subjects were enrolled. They were assigned to: group I, healthy volunteers without dyspeptic complaints (n=15); group II, patients with dysmotility-like dyspepsia (n=22); or group III, uremic patients undergoing hemodialysis with dysmotility-like dyspepsia (n=15). The data was compared among groups. RESULTS: There was no difference in the percentage of normal slow wave frequency, and fed to fasting power ratio among the groups. However, frequencies of abnormal EGG findings were 4 (27%) in group I, 10 (40%) group II and 9 (60%) in group III. Therefore the frequency was marginally different among group I, group II or group III (p=0.06). CONCLUSIONS: Impaired gastric myoelectric activity was more frequently observed in uremic patients or patients with dysmotility-like dyspepsia than normal controls. However frequencies of abnormal EGG findings between uremic patients and patients with dysmotility-like dyspepsia were not significantly different.