Renal Function Recovery in Chronic Dialysis Patients
Article first published online: 20 DEC 2010
© 2010 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 23, Issue 6, pages 606–613, November/December 2010
How to Cite
Chu, J. K. and Folkert, V. W. (2010), Renal Function Recovery in Chronic Dialysis Patients. Seminars in Dialysis, 23: 606–613. doi: 10.1111/j.1525-139X.2010.00769.x
- Issue published online: 22 DEC 2010
- Article first published online: 20 DEC 2010
Renal function recovery (RFR) from acute kidney injury requiring dialysis occurs at a high frequency. RFR from chronic dialysis, on the other hand, is an uncommon but well-recognized phenomenon, occurring at a rate of 1.0–2.4% according to data from large observational studies. The underlying etiology of renal failure is the single most important predicting factor of RFR in chronic dialysis patients. The disease types with the highest RFR rates are atheroembolic renal disease, systemic autoimmune disease, renovascular diseases, and scleroderma. The disease types with the lowest RFR rates are diabetic nephropathy and cystic kidney disease. Initial dialysis modality does not appear to influence RFR. Careful observation and history taking are needed to recognize the often nonspecific clinical and laboratory signs of RFR. When RFR is suspected in a chronic dialysis patient, a 24-hour urine urea and creatinine clearance should be measured. Based on the renal clearance, along with other clinical factors, the dialysis prescription may be gradually reduced until a complete discontinuation of dialysis. After RFR from maintenance dialysis, patients require close follow-up in an office setting for chronic kidney disease management.