A Collaborative Approach to Understanding EPS: The European Perspective

Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD), characterized by extensive sclerosis of the peritoneum with bowel adhesions, often causing bowel obstruction. In severe cases, the bowel becomes enveloped in a fibrotic cocoon, resulting in severe gastrointestinal symptoms. Patients commonly present with such symptoms and a history of weight loss. Time on PD is known to increase the risk. Most of the current knowledge about EPS comes from Japanese patients, who often remain on PD for long durations. In recent years, EPS outcomes in Japan seem to have improved because of the establishment of multicenter data collection and registries that have assisted in the development of optimal clinical management practices and surgical intervention. From the Japanese, we have learned that this collaborative approach can improve clinical and surgical management. Other countries such as the United Kingdom and Australia have also recognized the need for national collaboration. Since 2000, EPS has received growing attention in Europe because the causes and pathogenesis of this important syndrome are still not understood. Recent publications indicate that outcomes are improving, [...]