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

Macdonald, James A., McDonald, Stephen P., Hawley, Carmel M., Rosman, Johan, Brown, Fiona, Wiggins, Kathryn J., Bannister, Kym and Johnson, David W. (2009) Recovery of renal function in end-stage renal failure – Comparison between peritoneal and haemodialysis. Nephrology Dialysis Transplantation, 24 9: 2825-2831. doi:10.1093/ndt/gfp216


Author Macdonald, James A.
McDonald, Stephen P.
Hawley, Carmel M.
Rosman, Johan
Brown, Fiona
Wiggins, Kathryn J.
Bannister, Kym
Johnson, David W.
Title Recovery of renal function in end-stage renal failure – Comparison between peritoneal and haemodialysis
Journal name Nephrology Dialysis Transplantation   Check publisher's open access policy
ISSN 0931-0509
1460-2385
Publication date 2009-09
Sub-type Article (original research)
DOI 10.1093/ndt/gfp216
Volume 24
Issue 9
Start page 2825
End page 2831
Total pages 6
Editor Lameire, N.
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2010
Language eng
Formatted 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, 15 912 individuals received peritoneal dialysis (PD) and 23 658 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 Maori/Pacific 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.
Keyword Continuous ambulatory peritoneal dialysis
End-stage renal disease
Haemodialysis
Outcomes
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Tue, 13 Apr 2010, 17:01:09 EST by Maree Knight on behalf of Medicine - Princess Alexandra Hospital