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Verfasst von:Jagirdar, Rajesh M. [VerfasserIn]   i
 Bozikas, Andreas [VerfasserIn]   i
 Zarogiannis, Sotirios G. [VerfasserIn]   i
 Bartosova, Maria [VerfasserIn]   i
 Schmitt, Claus P. [VerfasserIn]   i
 Liakopoulos, Vassilios [VerfasserIn]   i
Titel:Encapsulating peritoneal sclerosis
Titelzusatz:pathophysiology and current treatment options
Verf.angabe:Rajesh M. Jagirdar, Andreas Bozikas, Sotirios G. Zarogiannis, Maria Bartosova, Claus Peter Schmitt, Vassilios Liakopoulos
E-Jahr:2019
Jahr:16 November 2019
Umfang:21 S.
Fussnoten:Gesehen am 14.04.2020
Titel Quelle:Enthalten in: International journal of molecular sciences
Ort Quelle:Basel : Molecular Diversity Preservation International, 2000
Jahr Quelle:2019
Band/Heft Quelle:20(2019,22) Artikel-Nummer 5765, 21 Seiten
ISSN Quelle:1422-0067
 1661-6596
Abstract:Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of long-term peritoneal dialysis (PD), which may even occur after patients have switched to hemodialysis (HD) or undergone kidney transplantation. The incidence of EPS varies across the globe and increases with PD vintage. Causative factors are the chronic exposure to bioincompatible PD solutions, which cause long-term modifications of the peritoneum, a high peritoneal transporter status involving high glucose concentrations, peritonitis episodes, and smoldering peritoneal inflammation. Additional potential causes are predisposing genetic factors and some medications. Clinical symptoms comprise signs of intestinal obstruction and a high peritoneal transporter status with incipient ultrafiltration failure. In radiological, macro-, and microscopic studies, a massively fibrotic and calcified peritoneum enclosed the intestine and parietal wall in such cases. Empirical treatments commonly used are corticosteroids and tamoxifen, which has fibrinolytic properties. Immunosuppressants like azathioprine, mycophenolate mofetil, or mTOR inhibitors may also help with reducing inflammation, fibrin deposition, and collagen synthesis and maturation. In animal studies, N-acetylcysteine, colchicine, rosiglitazone, thalidomide, and renin-angiotensin system (RAS) inhibitors yielded promising results. Surgical treatment has mainly been performed in severe cases of intestinal obstruction, with varying results. Mortality rates are still 25–55% in adults and about 14% in children. To reduce the incidence of EPS and improve the outcome of this devastating complication of chronic PD, vigorous consideration of the risk factors, early diagnosis, and timely discontinuation of PD and therapeutic interventions are mandatory, even though these are merely based on empirical evidence.
DOI:doi:10.3390/ijms20225765
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Kostenfrei: Volltext ; Verlag: https://doi.org/10.3390/ijms20225765
 Kostenfrei: Volltext ; Verlag: https://www.mdpi.com/1422-0067/20/22/5765
 Kostenfrei: Volltext: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887950
 DOI: https://doi.org/10.3390/ijms20225765
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:encapsulating peritoneal sclerosis
 fibrosis
 peritoneal dialysis
K10plus-PPN:1694480631
Verknüpfungen:→ Zeitschrift

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