Recovery of Kidney Function After Cessation of Graft Function or Prolonged Dialysis Treatment

Hansen, Britt Blaabjerg; Birkeland, Søren

doi:10.3109/00365598509180257

Cited by 9 publications

(4 citation statements)

References 2 publications

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“…R ecovery of dialysis-independent renal function has been reported to occur in 0.3% -8% of patients diagnosed to have end-stage (i.e., irreversible) renal disease (ESRD) (1)(2)(3)(4)(5)(6)(7)(8). Some studies have suggested that recovery of renal function is more common in patients treated with peritoneal dialysis (PD) than in those treated with hemodialysis (HD) (1,(6)(7)(8)(9), although other investigations have refuted this (1,3).…”

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confidence: 99%

Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis

et al. 2007

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Objectives The aim of this study was to investigate the factors affecting recovery and durability of dialysis-independent renal function following commencement of peritoneal dialysis (PD). Design Retrospective, observational cohort study of the Australian and New Zealand PD patient population. Setting Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Participants The study reviewed all patients in Australia and New Zealand who commenced PD for treatment of end-stage renal failure between 15 May 1963 and 31 December 2004. Main Outcome Measures The primary outcomes examined were recovery of dialysis-independent renal function and time from PD commencement to recovery of renal function. A secondary outcome measure was time to renal death (patient death or recommencement of renal replacement therapy) following recovery of dialysis-independent renal function. Results 24663 patients commenced PD during the study period. Of these, 253 (1%) recovered dialysis-independent renal function. An increased likelihood of recovery was predicted by autoimmune renal disease, hemolytic-uremic syndrome, paraproteinemia, cortical necrosis, renovascular disease, and treatment in New Zealand. A reduced likelihood of recovery was associated with polycystic kidney disease and indigenous race. Analysis of a contemporary subset of 14743 patients in whom complete data were available for body mass index, smoking, and comorbidities yielded comparable results, except that increasing age was additionally associated with a decreased likelihood of recovery. Of the 253 patients who recovered renal function, 151 (60%) recommenced renal replacement therapy and 49 (19%) died within a median period of 226 days (interquartile range 110 – 581 days). The only significant predictors of continued renal survival after renal recovery were autoimmune renal disease and cortical necrosis. Conclusions Recovery of renal function in patients treated with PD is rare and determined mainly by renal disease type and race. In the majority of cases, recovery is short term. The apparently high rate of early patient death or return to dialysis after recovery of renal function on PD raises questions about the appropriateness of discontinuing PD therapy under such circumstances.

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confidence: 99%

Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis

et al. 2007

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“…The temporary replacement of a kidney has allowed yost cases of acute tubular necrosis to recover spontaneously; it has also made it possible to treat and cure a number of other renal diseases. The recovery of native kidney function after the cessation of kidney graft function has also been observed [12]. We learn even more about kidney diseases when we observe recurrence of the disease in the graft or de novo appearance.…”

Section: Abstract Transplantation Lessons Lessons Transplantationmentioning

confidence: 87%

Lessons from transplantation and future perspectives

Birkeland¹

1998

Transplant International

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Organ transplantation is now a routine treatment for a number of chronic kidney, heart, lung, and liver diseases. We have accumulated much knowledge about these treatments in the respective disciplines, and it seems appropriate to reflect on some general "across-the-border" lessons that may be important for medicine as a whole. The natural history of several diseases has been extended; however, we have also learned much about temporary organ replacement, with the possibility of treating and, perhaps, also preventing some diseases in ways that were not possible in the past. This study explores the phenomenon of temporary organ replacement, whereby organs that are in danger in losing their function may recover in quiescence. It raises the question of whether there might be a common, underlying mechanism-such as apoptosis-for some very different diseases. Pharmacological interventions designed to modulate apoptosis are being developed that will hopefully reduce the amount of time needed for organs to recover their function. We have learned some lessons, but are there more possibilities that need to be explored?

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“…The term end-stage kidney disease denotes irreversible deterioration of renal function. A few patients, mainly adults, have been reported to regain independent renal function of their native kidneys after long-term dialysis [1,2,3,4,5,7,8,9]. Recovery mostly occurred within 6-12 months of initiating renal replacement therapy and was generally partial, both related to glomerular and tubular function.…”

Section: Discussionmentioning

confidence: 99%

“…Recovery of renal function of the native or transplanted kidneys after prolonged dialysis has rarely been reported, and mainly in adult patients [1,2,3,4,5,6,7,8,9,10]. We report on two children with hemolytic uremic syndrome (HUS) [11] who experienced a longlasting recovery of renal function after being on dialysis for 8 and 16 months, respectively.…”

Section: Introductionmentioning

confidence: 98%

Recovery of renal function after long-term dialysis in hemolytic uremic syndrome

Brunner

Bianchetti

Neuhaus

2004

Pediatric Nephrology

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Long-lasting recovery of renal function of the native kidneys after prolonged renal replacement therapy is rare. An 8-year-old girl and a 3-year-old boy had suffered from acute atypical and diarrhea-associated hemolytic uremic syndrome (HUS), respectively, with subsequent apparent end-stage renal failure. Both recovered renal function after long-lasting anuria and dialysis of 8 and 16 months, respectively. After prolonged follow-up, i.e., 7 and 5 years after cessation of dialysis, they attained normal or slightly reduced renal function (plasma creatinine 84 and 90 micro mol/l, respectively). In addition, growth and cognitive development were normal. We conclude that caution is appropriate before offering early renal transplantation to pediatric patients with presumed end-stage kidney disease secondary to HUS.

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Recovery of Kidney Function After Cessation of Graft Function or Prolonged Dialysis Treatment

Cited by 9 publications

References 2 publications

Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis

Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis

Lessons from transplantation and future perspectives

Recovery of renal function after long-term dialysis in hemolytic uremic syndrome

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