| [ Summary ] |
We attempted to clarify the risk factors related to mesothelial cell areas (MCA) in the effluent in terms of preventing encapsulating peritoneal sclerosis (EPS). We also developed an algorithm for the management of long-term PD patients. 247 patients were divided into two cohorts after PD withdrawal. These were termed the non-lavage group. 73 patients compromised the lavage group, of 174 patients. To clarify risk factors, including PD duration, D/P-Cr and MCA (PD area) at the time of PD withdrawal, and the MCA (LA area) at the time of peritoneal lavage withdrawal or censoring were set as the predictors. The overall incidence of EPS was significantly lower in the lavage group (6.9 %) than in the non-lavage group (15.1 %) . The risk factors and the cutoff values were determined as follows: PD area, 350 μm2 and PD duration, 78 months for the non-lavage group as well as PD area of 350 μm2 and LA area of 320 μm2 for the lavage group. Patients with PD duration 78 months and PD area 350 μm2 were defined as high-risk patients in the non-lavage group (incidence, 42.9 %：risk ratio, 11.14). Patients with PD area 350 μm2 and LA area 320 μm2 were defined as high-risk patients in the lavage group (incidence, 29.6 %: risk ratio, 10.43) . PD duration and MCA are significant risk factors. These markers are useful for classifying patients into low-and high-risk groups for the development of EPS. |