UMMS Affiliation

Department of Medicine, Division of Renal Medicine; Department of Pathology

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Document Type



Female Urogenital Diseases and Pregnancy Complications | Male Urogenital Diseases | Nephrology


Encapsulating peritoneal sclerosis is a rare, recurring complication in peritoneal dialysis (PD) patients. With a mortality rate of 51%, it continues to be a therapeutic enigma among clinicians. However, the incidence after kidney transplantation (KT) has rarely been reported. We report a unique case of encapsulating peritoneal sclerosis (EPS), occurring years after failed initial living KT, and diagnosed after second deceased donor kidney transplantation. A 35-year-old male, on prior PD for 4 years, followed by failed KT of 8 years, was presented with abdominal pain, weight loss, and vomiting, 7 months after his second deceased donor KT. An abdominal computed tomography showed intra-abdominal loculated fluid collection, but no obstruction. Exploratory laparotomy revealed extensive peritoneal thickening and blocked intestinal loops. Histopathology was indicative of EPS with fibrous adhesions and sclerotic tissues. Besides restarting his immunosuppressive medications, tamoxifen therapy was initiated as definitive medical management. Currently, he is in clinical remission, follows at transplant clinic, and still experiences episodes of small bowel obstruction. Though the incidence of EPS after KT has been observed sporadically worldwide, none has been reported in the USA. Despite its prevalence in PD patients, therapeutic interventions attempted so far, are not definitive.


Encapsulating peritoneal sclerosis, End-stage renal disease, Kidney transplantation, Peritoneal dialysis, Tamoxifen

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Copyright © 2021 by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) ( Usage and distribution for commercial purposes requires written permission.

DOI of Published Version



Roy S, Alexander K, Chowdhury MH, Vanguri V, Bodziak K. Encapsulating Peritoneal Sclerosis Presenting after Two Donor Kidney Transplantations: A Case Report and Literature Review. Case Rep Nephrol Dial. 2021 Jul 16;11(2):204-209. doi: 10.1159/000514062. PMID: 34414212; PMCID: PMC8339504. Link to article on publisher's site

Journal/Book/Conference Title

Case reports in nephrology and dialysis

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Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License