| [ Summary ] |
The Japanese guidelines for peritoneal dialysis (PD) recommend the discontinuation of PD with a due consideration of the risk of development of EPS. These were the first guidelines to do so. They were implemented to overcome the storm of encapsulating peritoneal sclerosis (EPS) cases in Japan in the 90's. On the other hand, the world wide PD community started discussions on issues related to preventing EPS. Although EPS development is dependant on the time of PD (peritoneal deterioration), the scientific evaluation of peritoneal deterioration and EPS risk factors are key factors. The Japanese guidelines emphasized that patients exhibiting serial increases in D/P Cr, resulting in high, sustained levels for twelve months or more, one may suspect progression of peritoneal deterioration. Discontinuation of PD should be considered in these cases. More evidence is required to prevent EPS associated with new biocompatible peritoneal dialysis solutions. |