A combination of corticosteroid, sirolimus, and intradialytic parenteral nutrition in encapsulating peritoneal sclerosis: Case report and literature review. Issue 3 (9th October 2016)

• Record Type: Journal Article
• Authors: Minetto Brabo, Alexandre; Soares Do Carmo Reis, Nayrana; Barretti, Pasqual; Ponce, Daniela
• Is Part Of: Hemodialysis international. Volume 21:Issue 3(2017)
• Page Start: 307
• Page End: 311
• Publication Date: 2016-10-09
• Subjects: Peritoneal dialysis -- encapsulating peritoneal sclerosis -- sirolimus -- intradialytic parenteral nutrition; Hemodialysis -- Periodicals; Renal Dialysis -- Periodicals; Renal Dialysis -- Congresses; Hemodialysis, Home -- Congresses; 617.461059
• DOI: 10.1111/hdi.12498
• Languages: English
• ISSNs: 1492-7535

Abstract

Abstract: Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS. Here, we present the first case of EPS treated successfully with a combination of sirolimus, low dose corticosteroid and intradialytic parenteral nutrition. A critical review of the relevant literature on this subject is also presented to determine the best approach.