RECENT EPIDEMIOLOGY AND CLINICAL OUTCOMES OF ENCAPSULATING PERITONEAL SCLEROSIS IN JAPAN

 

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RECENT EPIDEMIOLOGY AND CLINICAL OUTCOMES OF ENCAPSULATING PERITONEAL SCLEROSIS IN JAPAN

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Yukio
Maruyama
Yukio Maruyama maruyama@td5.so-net.ne.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan *
Nanae Matsuo nana77m@jikei.ac.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan -
Yudo Tanno yudo@msd.biglobe.ne.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan -
Masato Ikeda jikemasa@jikei.ac.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan -
Keitaro Yokoyama keitaro@jikei.ac.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan -
Masaaki Nakayama mnakayama1119@yahoo.co.jp St Luke's International University Division of Research Management Tokyo Japan -
Masanori Abe abe.masanori@nihon-u.ac.jp Nihon University School of Medicine Division of Nephrology, Hypertension and Endocrinology Tokyo Japan -
Takao Masaki masakit@hiroshima-u.ac.jp Hiroshima University Hospital Department of Nephrology Hiroshima Japan -
Takashi Yokoo tyokoo@jikei.ac.jp The Jikei University School of Medicine Division of Nephrology and Hypertension Tokyo Japan -
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Encapsulating peritoneal sclerosis (EPS) is one of the most serious complications of peritoneal dialysis (PD). Although the incidence and severity of EPS are said to have decreased with the advancement of PD managements including the widespread of biocompatible neutral PD solutions, the overall condition in Japan remains unclear.

We conducted an analysis using data extracted from the database of the Japanese Society for Dialysis Therapy Renal Data Registry. First, we examined the annual number of patients with EPS and changes in their background characteristics from 2012 to 2022. Next, we extracted baseline data for 12,752 dialysis patients from a registry in 2017 and investigated the association between a history of EPS and all-cause and cardiovascular mortality up to 2022, employing Cox regression analysis, competing-risks regression analysis, propensity score matching models, and Kaplan–Meier curves. Multiple imputation for missing values was performed.

In the first study, approximately 700 patients with EPS were identified every year (60–65% males; mean age, 61–66 years), accounting for 5% of the sum of PD patients and patients on other dialysis modalities with experience of PD. The crude death rate was approximately 5% and death from ileus was more frequent than in the total cohort of dialysis patients. In the second study, a history of EPS was not independently associated with higher all-cause and CV mortality in multivariate analysis (hazard ratio [HR] 1.13, 95% confidence interval [CI] 0.97-1.32; sub-HR [SHR] 1.02, 95%CI 0.78-1.33, respectively). Propensity score matching models including 1,845 dialysis patients revealed that all-cause mortality was not statistically different between patients with and without a history of EPS (Log-rank P=0.25, Figure 1). 

In this study utilizing a large-scale database of Japanese dialysis patients, we found that a considerable number of patients with EPS still exist. However, there was no significant difference in mortality rates between the EPS and non-EPS groups, suggesting that advances in PD care have led to improved clinical outcomes for patients with EPS.

Kewords