Is Encapsulating Peritoneal Sclerosis a Threatening Issue in Continuous Ambulatory Peritoneal Dialysis? The Japanese Experience

Encapsulating peritoneal sclerosis (EPS) is undoubtedly the most serious complication of continuous ambulatory peritoneal dialysis treatment in Japan, with a mortality rate ranging from about 39% to 49% in reported series. Cases of EPS have been linked to long-term peritoneal dialysis, and limitations on renal transplantation in Japan mean that most Japanese patients have to accept long-term dialysis therapy, which is a critical problem. Treatment alternatives for EPS include total parenteral nutrition, prednisolone administration, and surgical approaches, all of which have varying success rates. Additional therapeutic and new preventive measures have to be established for EPS.