Sclerosing peritonitis

The case presented in this study illustrates the peritoneal changes observe d in long-term peritoneal dialysis (PD) patients. This male patient was on peritoneal dialysis (CAPD) for seven months before and 86 months after rena l transplantation. Two episodes of peritonitis occurred during that time. T he patient developed symptoms (ascites, gastro-intestinal disturbances, det eriorating general condition, inflammatory syndrome) four months after star ting hemodialysis, one month after ablation of the PD catheter. Other poten tial causes (infection, malignancy, hepatitis, etc.) of these symptoms were ruled out following an exhaustive etiological work-up. A final diagnosis o f sclerosing peritonitis was made, and the patient was started on corticost eroid therapy. Both morphological and functional alterations of the peritoneal membrane as sociated with long term PD and the detection of such alterations in everyda y practice are reviewed here, along with possible etiological factors and t herapeutic measures discussed in the literature. A better understanding of the pathophysiological mecanisms underlying these alterations would make it possible to develop preventive measures, such as more biocompatible dialys ates.