Renal function recovery in dialysis dependent patients

Recovery of renal function in patients requiring chronic dialysis is an uncommon phenomenon. It is important to identify these patients to avoid unnecessary, complicated and expensive dialysis. There are no recognized indicators that actually suggest such revival of renal function. The aim of the study is to evaluate the indicators of renal recovery in dialysis patients.

It is a retrospective chart review of 299 patients who initiated chronic hemodialysis from January 2005 to June 2008. Ninety-eight patients were included in the study. Exact logistic regression analysis was used to determine the predictors of renal recovery.

Ten patients (3%) recovered their renal function. All of these patients had an episode of acute deterioration of renal function. Renal recovery correlated negatively with baseline serum albumin level (r=-0.53, P=<0.0001, age (r=-0.27, P=0.0054) and presence of hypertension (r=-0.30, P=0.0021) and DM (r=-0.30, P=0.0023) and positively with presence of human immunodeficiency virus infection (r=0.23, P=0.02). In multivariable exact logistic regression, analysis of low serum albumin level (exact odds ratio [OR] 27.09, P= 0.0008) and absence of DM (exact OR, 0.048, P=0.0002) were found to be the significant predictors of renal recovery.

It is important to be aware of the possibility of renal function recovery in chronic dialysis patients, especially in patients who are not diabetic, have episodes of acute renal failure, and started on dialysis with low serum albumin level.