| Theme |
Nutritional Guidance for Hemodialysis Patients with Complications |
| Title |
Sclerosing encapsulating peritonitis |
| Author |
Akio Imada |
Third Department of Internal Medicine, Kinki University School of Medicine |
| Author |
Nana Kanehira |
Division of Clinical Nutrition, Masuko Memorial Hospital |
| [ Summary ] |
Sclerosing encapsulating peritonitis is the most serious complication contraindicating continuance of CAPD. It is likely to develop after one year of since the ultrafiltration rate for the peritoneal membrane may fall or CAPD treatment may be discontinued. Detailed causative factors for SEP have not been elucidated yet. SEP related CAPD is the name given to the syndrome associated with this clinical diagnosis. The symptoms of intestinal obstruction associated with adhesions on the peritoneum must be confirmed by diagnostic imaging. Nutritional factors are administered through TPN (total parenteral nutrition), which is continued until the intestinal obstruction is dissolved. It is important to keep the level of serum albumin at the level of 3.6g/ml, and to adjust coagulation factors with the plasma fomulation. After resolution of the intestinal obstruction by steroidial or surgical treatment, we can gradually carry the treatment from the beginning stage of a fluid diet, on to internal feeding and on to solid food. Meanwhile, continued hemodialysis is necessary. |