Long Term Effects of PD

Does anyone know the long term effects of being on PD Dialysys. I have heard that over time the high dextrose soloution damages your peritoneum and cause major damage causing you to switch to hemo.
I believe it is called esp - encapsolated sclerosing peritonitis.
Can anyone add to it?

I’ve known PD patients who did PD for many years. In training for PD, patients are taught how to choose the PD solution based on their weight and other vital signs. Solutions with lower concentrations of dextrose are safer on the peritoneal membrane than the 4.25% dextrose solution. The 4.25% dextrose solution is used to take off more fluid. Sticking as closely as possible to the fluid limit will help you need less dextrose. Ways to limit fluids include
– ask the dietitian for tips for limiting fluids
– ask the doctor about medications that have thirst as a side effect
– limit sodium in foods (read labels)
– keep blood sugar under control if diabetic

I have encapsulating peritonitis. I did PD for eleven years. This is one of the reasons I stress to PD patients to reserve the use of 4.25% bags and 2.5% bags. Another major factor in my encapsualting peritonitis was surgeries. I had an omentum wrap. This created scar tissue and adhesions in my membrane. I also had mulitple hernia repairs that also caused problems. I had a few laprospic surgeries on my membrane to find out what was clotting my catheter. Encapsualting Peritonitis is not understood very well. You can get it even if you are not on PD. PD however does seem to be the main place it is showing up though. There is very little research on it and it is best if it is caught ealry. Triple contrast CT scans are about the only way it can be found and it is not something that is looked for. So it goes unnoticed untill a blockage forms most of the time. Tamoxiphin is the only known treatment for it, besides surgery. Surgery usualy is only a temporary fix because it just creates more scar tissue. Encapsulating Peritonitis attacks scar tissue. I have one of the best doctors at UCSF and he says that I am lucky that they caught it as early as they did.
Hope that helps;


I also have been diagnosed with encapsulating sclerosing peritonitis. As you know it is a very harsh and terrable condition that not many know about not to mention treating. You are right that not many Dr.s know what this is. I was lucky enouph to have one that recognized the symptoms.
I am very interested in discussing with you to compare treatment methods. I am also on tamoxiphin along with a few other drugs.
Do you have an email address that we can contact each other? I tried to PM you through this board, but for some reason was unable to.

Looking forward to hearing from you.

email is my name at yahoo.com

I’m about to start dialysis and I had chosen to do PD. But, I’ve since seen this article:


It says PD can increase your risk of dying by up to 50% over hemo if you have other health problems. Is it true? I have vasculitis in addition to kidney problems and this would seem to infer that hemo (hopefully home-hemo) would be a better choice.

Dear worried,

Thank you for visiting Home Dialysis Central. We actually addressed the findings of this study in one of our “Topic of the Month” articles, which you can read at: http://www.homedialysis.org/v1/rotating/0406topicofthemonth.shtml. We also have an article on why PD is a good first therapy: http://www.homedialysis.org/v1/rotating/0206topicofthemonth.shtml.

To summarize, the data from this study were collected fairly long ago–1995-2002. The first set of clinical practice guidelines for PD that included “adequacy” of treatment were not even released until 1997, and it took many years after that to put them into practice. So, PD today is different than it was then.

The main finding of that study was not so much that PD was harmful if there were other illnesses (there almost always are), but rather that survival was equivalent to HD in the first year, but suffered in the second year. This was most likely due to a failure to measure residual kidney function and adjust the PD dose to make up for it (something that is now in the guidelines).

I hope that you won’t allow the results of one study to change your mind. It’s also important to keep in mind that statistics apply to groups, not to individuals. As they say, “your mileage will vary.” Or, if you do decide not to do PD, please consider a home form of HD that will allow you to maintain your lifestyle and that would have fewer limits on your diet and fluids.

Thank you for the explanation, Dori. That does make sense and it’s a relief to me. I do still think I will go with PD. I have a verty good Nephrologist and I’m also very aware and involved in knowing what my labs are and what they should be, so it sounds like it will be okay.

The article didn’t really state why the people died, but your explanation makes sense to me. Thanks again!

Does anyone know of any other treatment for this disease? My niece has it and surgery is not an option,she is in hospital at the moment with small bowel obstruction and is on steroids and tamafoxin and is being fed via a nasal tube.I’ve been sending emails everywhere just in case someone knows something different to us.

I’m so sorry to hear about your niece. Steroids and tamoxifen appear to be the treatment of choice in the current medical literature–and the success rates have been high in small series’ of patients. I’m not aware of anything else, but perhaps one of our readers is?