Management strategies and insights in a complex, prolonged case of encapsulating peritoneal sclerosis
10.3760/cma.j.cn441217-20241211-01226
- VernacularTitle:复杂、长程包裹性腹膜硬化症患者1例的管理及思考
- Author:
Xianghui CHEN
1
;
Dongfeng GU
;
Jianbo LI
;
Yuanying LIU
;
Shurong LI
;
Fengxian HUANG
;
Wei CHEN
;
Haiping MAO
Author Information
1. 中山大学附属第一医院肾内科 国家卫生健康委员会肾脏病临床研究重点实验室（中山大学）广东省肾脏病重点实验室，广州 510080
- Publication Type:Journal Article
- Keywords:
Peritoneal dialysis;
Peritoneal fibrosis;
Risk factors
- From:
Chinese Journal of Nephrology
2025;41(8):615-619
- CountryChina
- Language:Chinese
-
Abstract:
This article reviews the diagnosis, therapeutic approaches, and subsequent care for a patient with a complex, long-standing history of encapsulating peritoneal sclerosis (EPS). A 40-year-old male, who had been on peritoneal dialysis (PD) for 11 years, encountered refractory peritonitis, leading to the removal of PD catheter and the subsequent diagnosis of EPS. The patient was transitioned to hemodialysis (HD) and prescribed tamoxifen to mitigate peritoneal fibrosis. After 4 months on HD, the patient underwent a kidney transplant, but acute rejection episode caused the transplanted kidney to fail 3 months postoperatively, necessitating a return to HD. Over the past 7 years, the patient has been repeatedly hospitalized due to recurrent bowel obstructions and infected abdominal fluid accumulation. A multidisciplinary approach, including anti-infective therapy, gastrointestinal intervention, nutritional support, and psychological care, has been instrumental in managing symptoms, and sustaining life. This case underscores the importance of recognizing EPS in long-term PD patients with peritonitis. While discontinuing PD, switching to HD, or receiving kidney transplantation do not halt the progression of EPS, optimized comprehensive management can extend the patient's survival.
