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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Encapsulating peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis (PD), associated with high mortality. The widespread adoption of more biocompatible, neutral-pH PD solutions has notably mitigated its incidence. In Japan, the combination therapy of PD and weekly hemodialysis (HD) is a common practice, allowing patients with declining residual kidney function to continue PD. Despite this context, reports concerning long-term peritoneal dialysis remain scarce. This study aims to investigate the clinical trajectories and outcomes of patients on exceptionally long-term PD at our institution and to elucidate the key factors associated with its sustained continuation.
We reviewed the medical records of patients who had been on PD for more than 15 years at our institution from April 2012 to July 2025. At our institution, comprehensive evaluations are routinely performed every six months, which include the peritoneal equilibration test (PET), as well as ultrasound, bioimpedance analysis (BIA), and nutritional counseling. These data were then analyzed retrospectively.
Thirteen patients (9 males) were enrolled. The mean age at PD initiation was 50.3 ± 8.1 years, and the mean body mass index (BMI) was 21.9 ± 2.9 kg/m2. The predominant primary causes of end-stage renal disease were glomerulonephritis (n = 11) and diabetic nephropathy (n = 2). The mean duration of the PD monotherapy was 4.8 ± 3.1 years and all the patients transitioned to the combination therapy of PD and HD. The total duration of PD, including combination therapy, was 16.3 ± 1.5 years. Importantly, none of the patients had a history of using low-pH PD solutions, and 12 had used high-glucose solutions. The peritonitis incidence rate was 0.094 episodes per patient-year. At the time of data analysis, nine patients had discontinued PD due to death (n = 2), infection (n = 2), or planned cessation (n = 7); two of these patients had upward trend of dialysate-to-plasma creatinine ratio (D/P Cr). At the most recent follow-up, PET showed a D/P Cr of 0.61 ± 0.11, and BIA showed excess fluid volume of 1.6 ± 1.1 L. Patients required an average of 0.38 types of antihypertensive drugs. The estimated daily sodium intake was 9.2 ± 2.2 g based on biochemical measurements from PD effluent and urine samples, and 5.8 ± 1.9 g from nutritionist-led interviews. The clinical course of these 9 patients after PD cessation was continuously monitored, for a cumulative follow-up duration of 22.9 years. One patient who discontinued PD due to escalating D/P Cr developed adhesive intestinal obstruction and required surgical adhesiolysis.
Our findings demonstrate that long-term PD at our institution is associated with a low peritonitis incidence and relatively well-maintained fluid status. These favorable clinical results appear to be the key determinants enabling the sustained continuation of PD for exceptionally long periods. Continued long-term follow-up of these patients, particularly after PD cessation, is crucial for a comprehensive assessment of the therapy's overall long-term safety, especially regarding the potential for late-onset EPS.
