Recovery of renal function in end-stage renal failure - Comparison between peritoneal dialysis and haemodialysis

James A. MacDonald, Stephen McDonald, Carmel M. Hawley, Johan Rosman, Fiona Brown, Kathryn J. Wiggins, Kym Bannister, David W. Johnson

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19 Citations (Scopus)

Abstract

Background. Recovery of dialysis-independent renal function in long-term dialysis patients has not been studied extensively. The aim of this study was to investigate the effect of dialysis modality on the likelihood, timing and durability of recovery of dialysis-independent renal function.Methods. The study reviewed all patients in Australia and New Zealand who commenced dialysis for treatment of end-stage renal disease (ESRD) between 1963 and 2006. Dialysis modality was assigned at 90 days. A supplementary analysis was also conducted using a contemporary cohort that included data on comorbidities, smoking and eGFR at dialysis onset.Results. During the study period, 15912 individuals received peritoneal dialysis (PD) and 23658 received haemodialysis (HD). Renal recovery occurred in 176 (1.1) PD and 244 (1.0) HD patients. Using multivariate Cox proportional hazards regression analyses, dialysis modality was not independently predictive of time to renal recovery (HR 0.92, 95 CI 0.76-1.13, P = 0.4). Recovery was significantly more likely in patients with higher baseline eGFR, with no hypertension or peripheral vascular disease, and with certain causes of kidney failure (autoimmune renal disease, haemolytic uraemic syndrome, interstitial nephritis, obstructive uropathy, paraproteinaemia and renovascular nephrosclerosis). Recovery was less likely in MaoriPacific Islanders and polycystic kidney disease. Among patients who recovered, 328 (78) subsequently experienced renal death, mostly within the first year. The duration of renal recovery was not associated with initial dialysis modality (OR 0.82, 95 CI 0.50- 1.32).Conclusions. Dialysis modality is not associated with the likelihood, timing or durability of spontaneous recovery of dialysis-independent renal function in patients thought to have ESRD.

LanguageEnglish
Pages2825-2831
Number of pages7
JournalNephrology Dialysis Transplantation
Volume24
Issue number9
DOIs
Publication statusPublished - 1 Sep 2009
Externally publishedYes

Keywords

  • Continuous ambulatory peritoneal dialysis
  • End-stage renal disease
  • Haemodialysis
  • Outcomes
  • Residual renal function

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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