Recovery from end-stage renal disease

To evaluate the rate and associated factors for recovery of renal function in patients labeled by their nephrologists as having end-stage renal disease (ESRD), the data base of the Michigan Kidney Registry was used. All patients reported as starting treatment for ESRD between 1976 and 1985 (N = 7,404) were evaluated, excluding patients with acute tubular necrosis (ATN) or transplantation cases. While patients with ESRD due to diabetes and cystic diseases had lower recovery rates than average, patients with glomerulonephritis associated with a systemic illness, vasculopathies, and crescents had threefold to fourfold higher recovery rates. White race, older age, and later year of ESRD were associated with significantly higher recovery rates. Recovery rates did not differ substantially for patients receiving peritoneal dialysis or hemodialysis. Recovery occurred within 6 months of ESRD in approximately 48% of those recovering, 74% within 1 year, and lasted at least 1 year in 75% of the cases. The authors conclude that caution should be applied when the diagnosis of ESRD is made; the possibility of recovery should be sought and assessed, especially when early renal transplantation is considered.