Peritoneal sclerosis: One or two nosological entities?

The frequency, pathology, animal models, pathogenesis, clinical manifestati ons, diagnostic criteria, therapy and prevention of peritoneal sclerosis ar e reviewed. Many of these aspects have a bimodal configuration which sugges ts that peritoneal sclerosis, usually considered a single pathology in peri toneal dialysis, is actually two distinct nosological entities: simple scle rosis and sclerosing peritonitis. The former is very frequent, with minor a natomical alterations and low clinical impact; it is reproducible in animal s by means of peritoneal dialysis, and is clearly due to the poor biocompat ibility of peritoneal dialysis solutions. The latter is rare, with radical anatomical alterations and high mortality requiring Valid methods of diagno sis, therapy and prevention; it can only be reproduced in animal models by means other than peritoneal dialysis and seems to be due to factors both re lated and unrelated to peritoneal dialysis.