Encapsulating peritoneal sclerosis (EPS) is the most serious and life-threatening complication of peritoneal dialysis (PD) therapy, as mortality is extremely high once it occurs. According to recent reports, mortality rate of EPS is 14 – 84%. Extensive fibrosing of the peritoneum in patients with EPS leads to symptoms of malnutrition and small bowel obstruction (ileus). Encapsulation can progress so that the bowel eventually becomes completely cocooned. The outcomes of several medical approaches such as tamoxifen, steroids, and newer immunosuppressive agents to retard EPS progression remain poor. Moreover, in some alive cases, surgical approach (enterolysis, peritonectomy) is inevitable to cure symptoms of ileus.
Dissolved hydrogen (H2) has a unique biological antioxidative and anti-inflammatory capacity. Accumulating evidence suggests that H2 ameliorates organ damage in various models of ischemia and inflammation. Clinical applications of H2 to pro-inflammatory disorders have been investigated, particularly for use during hemodialysis (HD) therapy. In addition, we recently showed that peritoneal dialysate containing high H2 concentrations could reduce both peritoneal and systemic oxidative stress in the clinical setting.
In the present case study, dialysate enriched with H2 for both haemodialysis (HD) therapy and peritoneal lavage caused symptoms and laboratory signs of EPS to decrease.