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EPS Pharmacological Treatment — ESENeph MCQ

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HardPeritoneal DialysisEPS Pharmacological TreatmentESENeph

A 65-year-old man with CKD G5D on PD develops sclerosing encapsulating peritonitis (SEP/EPS) after 8 years on PD. He has switched to HD. CT shows peritoneal thickening and tethered bowel loops. He has intermittent small bowel obstruction. Which medication has been used as adjunctive therapy?

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Correct answer: E — Tamoxifen

Tamoxifen (an anti-oestrogen with anti-fibrotic properties) has been used as adjunctive treatment for EPS based on case series showing reduction in peritoneal inflammation and fibrosis. While evidence is limited and no RCTs exist, it remains the most commonly used pharmacological adjunct alongside nutritional support and surgical enterolysis for symptomatic obstruction. Corticosteroids have also been used but with variable success.

Reference: UKKA 2009 – EPS Guidelines; Korte et al 2011 – EPS Management Review