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Renal function recovery in end-stage renal disease
V Pichette1, S Quérin, M Desmeules
1Service de Néphrologie, Hôtel-Dieu de Montréal, Quebec, Canada.
Summary
Renal function recovery in end-stage renal disease patients is rare (2.4%). Myeloma and drug-induced diseases predicted higher recovery rates, while diabetes and polycystic kidneys predicted lower rates.
Area of Science:
- Nephrology
- Epidemiology
- Clinical Medicine
Background:
- Renal function recovery (RFR) in end-stage renal disease (ESRD) patients is infrequent, with limited understanding of predictive factors.
- Existing research highlights some factors, but a comprehensive analysis in a large population is needed.
Purpose of the Study:
- To determine the incidence of RFR in a large ESRD cohort.
- To identify factors predictive of RFR and analyze outcomes post-recovery.
Main Methods:
- Analysis of the Canadian Organ Replacement Register data from 1981-1989.
- Inclusion of 14,318 ESRD patients, excluding those on renal replacement therapy (RRT) for <= 45 days.
- Definition of RFR as RRT interruption for > 3 months; Cox regression analysis for predictive factors.
Main Results:
- A total of 342 patients (2.4%) achieved RFR after a mean of 8.9 months of RRT.
- Higher RFR rates were associated with myeloma (RR=6.00), drug-induced disease (RR=4.21), vascular/hypertensive disease (RR=2.60), and systemic disease (RR=2.58) compared to glomerulonephritis.
- Lower RFR rates were observed in polycystic kidney disease (RR=0.06) and diabetic patients (RR=0.56). Younger men (<45 years) had lower RFR rates than older men and women.
Conclusions:
- The incidence of renal function recovery in ESRD patients is low.
- Specific diagnoses (myeloma, drug-induced, vascular, systemic diseases) and younger male gender are associated with RFR.
- Polycystic kidney disease and diabetes are associated with a lower likelihood of RFR.