Introduction:
Recovery of kidney function (RKF) in end-stage kidney disease (ESKD) patients on long-term dialysis patients has not been studied extensively. Outsourcing of chronic dialysis services is a new practice in the Kingdom of Saudi Arabia. The aim of this study was to assess the incidence and factors predictive of RKF in a large ESKD population as well as the outcome after recovery.
Methods:
The study reviewed 9427 patients in Saudi Arabia who dialyzed with Diaverum outsourcing program between June,2013 and June 2024. Kidney function recovery was defined as the interruption of kidney replacement therapy (KRT) for more than 3 months.
Results:
Thirty patients (0.03%) experienced recovery of kidney function correspond to the incidence of 0.934 per 1000 patient-years. 80% of the RKF events occurred in the first 6 months of dialysis initiation. The group consisted of 7 (39%) males and 11 (61%) females. Patients were 59 ± 12.8 years old. The primary disease was diabetic nephropathy in 20 out of the 30 cases, vascular nephropathy in 4/30 cases, glomerulonephritis in 3/20 cases and unknown nephropathy in 3/30 cases. Dialysis was initiated due to uremic symptoms in 11 patients, fluid overload in 12 patients, metabolic acidosis in 2 patients, and hyperkalemia in 5 patients. Median dialysis duration was 5 (1 to 20) months. The mean urine output at dialysis initiation was 1.6 ± 0.5 l/day. Their mean initiation creatinine and BUN levels were 4.68 ± 3 mg/dl and 21 ± 11.5 mmol/l, respectively. The mean creatinine and BUN levels at dialysis cessation were 2.15 ± 0.78 mg/dl and 12 ± 6 mmol/l, respectively, while the mean eGFR was 36 ± 18.9 ml/min. Upon discontinuation, they remained dialysis free for median period of 4 (1 to 19) months.
Conclusions:
The present study demonstrated that recovery of kidney function in the outsourcing dialysis clinics following in-hospital KRT initiation is not rare, generally short-lived and primarily determined by underlying primary kidney disease. All physicians must be aware of possible kidney function recovery during the first 6 months.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.