Estimating risk of encapsulating peritoneal sclerosis accounting for the competing risk of death.

If the baseline risk of the SRR population was used ( Figure 3 ), then the risk of EPS remained low compared with the risk of death in those patients at high risk of death, but became highly significant for patients at low risk of death 5 years after the start of PD.

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The challenge for safe and effective management is estimating when the risk of future EPS becomes sufficiently high to justify switching to HD, as there may be significant disruption to the patient’s quality of life and little length of life advantage.

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