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Rev. méd. Chile ; 145(1): 41-48, ene. 2017. ilus, graf, tab
Article Dans Espagnol | LILACS | ID: biblio-845502

Résumé

Background: Encapsulating peritoneal sclerosis (EPS) is a complication of peritoneal dialysis (PD) with a low prevalence but high mortality. It is characterized by peritoneal inflammation and fibrosis with subsequent development of intestinal encapsulation. It is associated with a long lapse on PD, frequent episodes of peritonitis, high glucose solution use, and high peritoneal transport status. Aim: To report the clinical features of patients on PD, who developed EPS. Material and Methods: Review of medical records of 12 patients aged 43 ± 10 years (eight women) who developed EPS. Results: The mean time spent on PD was 98 months. The main clinical manifestations were abdominal pain in 82% and ultrafiltration failure in 63%. In 92%, there was a history of peritonitis and 75% had high peritoneal transport at the time of diagnosis. The main findings in computed tomography were peritoneal calcification and thickening. There was a biopsy compatible with the diagnosis in 10 cases. Treatment consisted in withdrawal from PD, removal of PD catheter and the use of corticoids and tamoxifen. After withdrawal from PD 50% of patients became asymptomatic. The rest had intermittent abdominal pain and altered bowel movements. Two patients died (17%). Conclusions: EPS is a serious complication of PD, which should be suspected in any patient with compatible clinical symptoms, long time on PD, multiple episodes of peritonitis and high peritoneal transport profile.


Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Péritonite/diagnostic , Péritonite/étiologie , Dialyse péritonéale/effets indésirables , Fibrose péritonéale/étiologie , Péritonite/anatomopathologie , Péritonite/thérapie , Chili , Études rétrospectives , Facteurs de risque , Fibrose péritonéale/anatomopathologie , Fibrose péritonéale/thérapie , Défaillance rénale chronique
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