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首页> 外文期刊>Peritoneal dialysis international: Journal of the International Society for Peritoneal Dialysis >Peritoneal dialysis in Japan: the issue of encapsulating peritoneal sclerosis and future challenges.
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Peritoneal dialysis in Japan: the issue of encapsulating peritoneal sclerosis and future challenges.

机译：日本的腹膜透析：封装腹膜硬化的问题和未来的挑战。

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摘要

Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD). The overall prevalence of EPS in Japanese PD patients is 2.3%. Among patients on PD for less than 5 years, the rate is 0.9%; among patients on PD for 5 - 10 years, the rate is 3.8%; and among patients on PD for >10 years, it is 11.5%. Thus, the longer the treatment duration, the higher the prevalence of EPS. Encapsulating peritoneal sclerosis does not result solely from the natural progression of peritoneal sclerosis. A "second hit" event, such as bacterial peritonitis, abdominal bleeding, or abdominal surgery may be needed to trigger the onset of EPS in the face of advanced peritoneal sclerosis. To prevent development of EPS, PD treatment is replaced by other treatments when patients reached high-transport status. Peritoneal lavage and prednisolone administration have been reported to be effective in preventing or stopping the progress of EPS. When bowel obstruction has occurred, total enterolysis to remove the fibrous capsule from the bowel is indicated. To maximize overall quality of life, patients with endstage renal disease (ESRD) should have the choice to make use of all the treatment modalities available: PD, hemodialysis (HD), and transplantation. Furthermore, the development of truly biocompatible PD equipment--including peritoneal catheters, solutions, and systems--are desirable to extend PD treatment for the long-term. The cost of individual products could decrease significantly if PD use were to increase to 30% from 10% among ESRD patients worldwide. As practitioners, we have to further improve the technical survival rate and functional duration of PD treatment so that adequate peritoneal function can be maintained for 10 years in at least 40% of PD patients. The goal is to place PD on par with HD using high-flux dialysis membranes and ultrapure dialysis solution.
机译：封装性腹膜硬化症（EPS）是危及生命的腹膜透析（PD）并发症。日本PD患者的EPS总体患病率为2.3％。在PD少于5年的患者中，该比率为0.9％;接受PD治疗5-10年的患者中，这一比率为3.8％;在PD≥10年的患者中，这一比例为11.5％。因此，治疗时间越长，EPS的患病率越高。包囊性腹膜硬化并非仅由腹膜硬化的自然发展引起。面对晚期腹膜硬化，可能需要“二次打击”事件，例如细菌性腹膜炎，腹部出血或腹部手术来触发EPS的发作。为了防止EPS的发展，当患者达到高运输状态时，PD治疗将被其他治疗替代。据报道，腹腔灌洗和泼尼松龙可有效预防或阻止EPS的进展。当肠梗阻发生时，需要进行彻底肠溶以从肠中去除纤维囊​​。为了使整体生活质量最大化，患有终末期肾病（ESRD）的患者应选择使用所有可用的治疗方式：PD，血液透析（HD）和移植。此外，需要开发一种真正具有生物相容性的PD设备（包括腹膜导管，溶液和系统），以长期扩展PD治疗。如果将PD使用率从全球ESRD患者中的10％增加到30％，则单个产品的成本可能会大大降低。作为从业者，我们必须进一步提高PD治疗的技术存活率和功能持续时间，以使至少40％的PD患者能够保持足够的腹膜功能10年。目标是使用高通量透析膜和超纯透析溶液将PD与HD放在一起。

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