Journal articles: 'Renal recovery'

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Goldstein, Stuart L., Lakhmir Chawla, Claudio Ronco, and John A. Kellum. "Renal recovery." Critical Care 18, no. 1 (2014): 301. http://dx.doi.org/10.1186/cc13180.

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Göcze, Ivan, Christina Wiesner, Hans J. Schlitt, and Tobias Bergler. "Renal recovery." Best Practice & Research Clinical Anaesthesiology 31, no. 3 (September 2017): 403–14. http://dx.doi.org/10.1016/j.bpa.2017.08.006.

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Bell, Max, Lakhmir S. Chawla, and R. Wald. "Understanding renal recovery." Intensive Care Medicine 43, no. 6 (March 23, 2017): 924–26. http://dx.doi.org/10.1007/s00134-017-4773-5.

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Craven, Ann-Maree S., Carmel M. Hawley, Stephen P. McDonald, Johan B. Rosman, Fiona G. Brown, and David W. Johnson. "Predictors of Renal Recovery in Australian and New Zealand end-Stage Renal Failure Patients Treated with Peritoneal Dialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 27, no. 2 (March 2007): 184–91. http://dx.doi.org/10.1177/089686080702700216.

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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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Pothugunta, Krishna, Santhi Voora, Holly Joy Kramer, Anil K. Bidani, and Kavitha Vellanki. "Outcomes of Albumin Use in the Treatment of Acute Hepatorenal Disorders: A Single Center Experience." Journal of Renal and Hepatic Disorders 1, no. 1 (February 3, 2017): 5–10. http://dx.doi.org/10.15586/jrenhep.2017.2.

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Intravenous albumin is recommended for hepatorenal disorders (HRD), but individuals who do not recover renal function may be at a high risk for pulmonary edema. We reviewed outcomes by the amount of albumin infused in 93 patients not receiving dialysis at admission but being treated with intravenous albumin for acute HRD at our institution. Absence of renal recovery was defined as no decrease in serum creatinine and requirement of dialysis during hospitalization, and partial renal recovery was defined as a decrease in serum creatinine but not to prehospitalization levels. Associations of clinical factors including total albumin infused, presence of renal recovery, and oliguria with the development of pulmonary edema during hospitalization were determined using logistic regression. Of the 93 patients, 20 patients had complete renal recovery, 17 patients had partial renal recovery, and 56 patients showed no renal recovery. Most patients received 300–600 g of albumin. Overall, 47.3% of patients developed pulmonary edema (n=44), but the risk was 75% in patients with oliguria on presentation and no renal recovery versus 17% in those with no oliguria and complete renal recovery (P<0.001). In the logistic regression model, oliguria (3.32; 95% confidence interval [CI]: 1.12, 9.81) and no renal recovery (3.38; 95% CI:1.24, 9.16) were each associated with higher odds of pulmonary edema after adjustment for covariates. No association was noted between total albumin infused and pulmonary edema. In summary, absence of renal recovery and oliguria in patients with HRD receiving intravenous albumin is associated with a higher risk of pulmonary edema.

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Personett, Heather A., Bryce M. Kayhart, Erin F. Barreto, Pritish Tosh, Ross Dierkhising, Kristin Mara, and Nelson Leung. "Renal Recovery following Liposomal Amphotericin B-Induced Nephrotoxicity." International Journal of Nephrology 2019 (January 28, 2019): 1–8. http://dx.doi.org/10.1155/2019/8629891.

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Background. Acute kidney injury (AKI) is a common complication of treatment with liposomal amphotericin B (LAmB). The trajectory of renal recovery after LAmB-associated AKI has not been well described, nor has effect of LAmB dose on recovery of renal function been explored. Objective. Characterize the pattern of renal recovery after incident AKI during LAmB and determine potential influencing factors. Methods. This retrospective cohort study analyzed patients who developed a ≥50% increase in serum creatinine while on LAmB. Patients were followed up until complete renal recovery or death or for 30 days, whichever occurred first. The primary outcome was complete renal recovery, defined as serum creatinine convalescence to within 10% of the patient’s pretreatment baseline. Multivariable modeling was used to identify independent predictors of renal recovery. Results. Ninety-eight patients experienced nephrotoxicity during LAmB, 94% of which received doses <7 mg/kg/day. Fifty-one patients at least partially recovered renal function and, of these, 32 exhibited complete recovery after a mean 9.8 ± 7.8 days. No statistical relationship was found between LAmB dose at the time of AKI or cumulative exposure to LAmB and the likelihood of renal recovery. Concomitant nephrotoxins, age, and pretreatment renal function did not modify this effect in multivariable analysis. Conclusion and Relevance. Our data suggests that LAmB dose did not impact the likelihood of renal recovery. Additional investigation is needed to confirm these findings when aggressive dosing strategies are employe. Additional research is also warranted to further characterize the course of recovery after LAmB-associated nephrotoxicity and comprehensive spectrum of renal outcomes.

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Liu, Kathleen D., and Paul R. Brakeman. "Renal repair and recovery." Critical Care Medicine 36, Suppl (April 2008): S187—S192. http://dx.doi.org/10.1097/ccm.0b013e318168ca4a.

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Bagshaw, S. M., G. Mortis, T. Godinez-Luna, C. J. Doig, and K. B. Laupland. "Renal Recovery after Severe Acute Renal Failure." International Journal of Artificial Organs 29, no. 11 (November 2006): 1023–30. http://dx.doi.org/10.1177/039139880602901102.

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Lee, J. S., J. S. Oh, Y.-G. Kim, C.-K. Lee, B. Yoo, and S. Hong. "Recovery of renal function in patients with lupus nephritis and reduced renal function: the beneficial effect of hydroxychloroquine." Lupus 29, no. 1 (December 2, 2019): 52–57. http://dx.doi.org/10.1177/0961203319890007.

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Background Reduced renal function is associated with worse renal outcome in patients with lupus nephritis (LN). However, there is insufficient knowledge regarding renal function recovery in patients with LN with reduced baseline renal function. Therefore, the present study aimed to investigate renal function recovery and related factors in patients with reduced baseline renal function. Methods The present retrospective longitudinal cohort study included patients with LN and reduced renal function. Reduced renal function was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Recovery of renal function was determined by an eGFR of >60 mL/min/1.73 m2 at six months after baseline, and factors associated with it were evaluated using logistic regression analysis. Results We included 90 patients with LN, with a mean eGFR value of 37.2 ± 13.9 mL/min/1.73 m2. Forty-six (51.1%) patients recovered their renal function after six months. On multivariate analysis, hydroxychloroquine use (odds ratio (OR) = 3.891, 95% confidence interval (CI) 1.196–12.653, p = 0.024), prolonged LN (OR = 0.926, 95% CI 0.874–0.981, p = 0.009) and high-grade tubular atrophy (OR = 0.451, 95% CI 0.208–0.829, p = 0.013) were associated with renal function recovery. During follow up, 25 patients were on end-stage renal disease (ESRD). Kaplan–Meier analysis revealed that renal function recovery after six months and lower probability of ESRD are associated. Conclusions In patients with LN and reduced renal function, renal function recovery at six months was associated with use of hydroxychloroquine and inversely related to longer duration of LN and higher grade of tubular atrophy.

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Taverner, D., D. J. Harrison, and G. M. Bell. "Acute Renal Failure Due to Interstitial Nephritis Induced by ‘Glue-Sniffing’ with Subsequent Recovery." Scottish Medical Journal 33, no. 2 (April 1988): 246–47. http://dx.doi.org/10.1177/003693308803300208.

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We report a case of the deliberate inhalation of a toluene-containing adhesive which caused acute renal failure and hepatic damage. Renal biopsy disclosed a severe tubulo-interstitial nephritis, renal function recovered after 14 days' haemodialysis. The literature on renal complications of toluene exposure is reviewed, this is the only case of acute renal failure due to interstitial nephritis after toluene exposure with subsequent recovery. Recovery in this case may have been related to the avoidance of further toluene exposure.

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Nowak, Grazyna, Judit Megyesi, and William J. Craigen. "Deletion of VDAC1 Hinders Recovery of Mitochondrial and Renal Functions After Acute Kidney Injury." Biomolecules 10, no. 4 (April 10, 2020): 585. http://dx.doi.org/10.3390/biom10040585.

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Voltage-dependent anion channels (VDACs) constitute major transporters mediating bidirectional movement of solutes between cytoplasm and mitochondria. We aimed to determine if VDAC1 plays a role in recovery of mitochondrial and kidney functions after ischemia-induced acute kidney injury (AKI). Kidney function decreased after ischemia and recovered in wild-type (WT), but not in VDAC1-deficient mice. Mitochondrial maximum respiration, activities of respiratory complexes and FoF1-ATPase, and ATP content in renal cortex decreased after ischemia and recovered in WT mice. VDAC1 deletion reduced respiration and ATP content in non-injured kidneys. Further, VDAC1 deletion blocked return of activities of respiratory complexes and FoF1-ATPase, and recovery of respiration and ATP content after ischemia. Deletion of VDAC1 exacerbated ischemia-induced mitochondrial fission, but did not aggravate morphological damage to proximal tubules after ischemia. However, VDAC1 deficiency impaired recovery of kidney morphology and increased renal interstitial collagen accumulation. Thus, our data show a novel role for VDAC1 in regulating renal mitochondrial dynamics and recovery of mitochondrial function and ATP levels after AKI. We conclude that the presence of VDAC1 (1) stimulates capacity of renal mitochondria for respiration and ATP production, (2) reduces mitochondrial fission, (3) promotes recovery of mitochondrial function and dynamics, renal morphology, and kidney functions, and (4) increases survival after AKI.

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Bagshaw, Sean M. "Epidemiology of renal recovery after acute renal failure." Current Opinion in Internal Medicine 6, no. 1 (February 2007): 31–37. http://dx.doi.org/10.1097/01.ccx.0000247444.63758.0b.

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Pichette, Vincent, Serge Quérin, Marie Desmeules, Jean Ethier, and Pauline Copleston. "Renal Function Recovery in End-Stage Renal Disease." American Journal of Kidney Diseases 22, no. 3 (September 1993): 398–402. http://dx.doi.org/10.1016/s0272-6386(12)70142-7.

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Szeto, Cheuk-Chun, and Kai-Ming Chow. "Residual Renal Function and Recovery of Renal Function." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 27, no. 2 (March 2007): 159–61. http://dx.doi.org/10.1177/089686080702700211.

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Davis, Connie. "Sirolimus Delays Renal Allograft Recovery." American Journal of Transplantation 3, no. 4 (April 2003): 363–65. http://dx.doi.org/10.1034/j.1600-6143.2003.00116.x.

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Goldstein, Stuart L. "Renal Recovery at Different Ages." Nephron Clinical Practice 127, no. 1-4 (September 24, 2014): 21–24. http://dx.doi.org/10.1159/000363679.

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Godin, Mélanie, Etienne Macedo, and Ravindra L. Mehta. "Clinical Determinants of Renal Recovery." Nephron Clinical Practice 127, no. 1-4 (September 24, 2014): 25–29. http://dx.doi.org/10.1159/000363707.

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Wu, Chung-Kuan, Chia-Lin Wu, Tzu-Cheng Su, Yu Ru Kou, Chew-Teng Kor, Tzong-Shyuan Lee, and Der-Cherng Tarng. "Renal Tubular TRPA1 as a Risk Factor for Recovery of Renal Function from Acute Tubular Necrosis." Journal of Clinical Medicine 8, no. 12 (December 11, 2019): 2187. http://dx.doi.org/10.3390/jcm8122187.

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Background: Transient receptor potential ankyrin 1 (TRPA1), a redox-sensing Ca2+-influx channel, serves as a gatekeeper for inflammation. However, the role of TRPA1 in kidney injury remains elusive. Methods: The retrospective cohort study recruited 46 adult patients with acute kidney injury (AKI) and biopsy-proven acute tubular necrosis (ATN) and followed them up for more than three months. The subjects were divided into high- and low-renal-tubular-TRPA1-expression groups for the comparison of the total recovery of renal function and mortality within three months. The significance of TRPA1 in patient prognosis was evaluated using Kaplan–Meier curves and logistic regression analysis. Results: Of the 46 adult AKI patients with ATN, 12 totally recovered renal function. The expression level of tubular TRPA1 was detected by quantitative analysis of the immunohistochemistry of biopsy specimens from ATN patients. The AKI patients with high tubular TRPA1 expression showed a high incidence of nontotal renal function recovery than those with low tubular TRPA1 expression (OR = 7.14; 95%CI 1.35–37.75; p = 0.02). High TRPA1 expression was independently associated with nontotal recovery of renal function (adjusted OR = 6.86; 95%CI 1.26–37.27; p = 0.03). Conclusion: High tubular TRPA1 expression was associated with the nontotal recovery of renal function. Further mechanistic studies are warranted.

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Jacka, Michael J., Xenia Ivancinova, and R. T. Noel Gibney. "Continuous renal replacement therapy improves renal recovery from acute renal failure." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 52, no. 3 (March 2005): 327–32. http://dx.doi.org/10.1007/bf03016071.

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Nhat M, Giang, Nguyen Hai H, and Chau Ngoc-Hoa. "Renal kinetics in acute heart failure." Open Heart 7, no. 1 (June 2020): e001173. http://dx.doi.org/10.1136/openhrt-2019-001173.

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AimsWorsening renal function (WRF) in acute heart failure (AHF) has multifactorial pathophysiological mechanisms and heterogeneous prognostic impacts. The aim of this study was to determine the characteristics and renal kinetics of this phenomenon.Methods and resultsWe prospectively enrolled a cohort of 196 patients admitted for AHF to the Cardiology Department at Nhan Dan Gia Dinh Hospital, from July 2016 to March 2017. AHF was defined using the 2012 European Society of Cardiology criteria. The definition and severity of WRF were based on the 2012 Kidney Disease Improving Outcome criteria for acute kidney injury. Renal recovery was classified using the 2017 Acute Disease Quality Initiative 16 Workgroup Consensus. Among the 196 patients studied, WRF developed in 43.4%. In 80.0% of patients, WRF occurred within 48 hours of admission. In the WRF group, 89.4% were at stage 1, consistent with a relative increase in median serum creatinine of 49.5%. A total of 76.5% of the patients with WRF recovered at discharge, while rapid recovery occurred in 20.0% of patients.ConclusionsMost cases of WRF were mild, and WRF was correlated with a high rate of recovery during hospitalisation. However, rapid renal recovery was not common.

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Boydstun, Ivy, Samer Najjar, Michael Kashgarian, Thomas Carpenter, and Norman Siegel. "Postischemic thyroxin stimulates renal mitochondrial adenine nucleotide translocator activity." American Journal of Physiology-Renal Physiology 268, no. 4 (April 1, 1995): F651—F656. http://dx.doi.org/10.1152/ajprenal.1995.268.4.f651.

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Postischemic thyroxin (T4) enhances restitution of cellular ATP and accelerates recovery of renal function. This effect is not related to global improvement in cell integrity. To determine the mechanism by which recovery of cellular ATP is enhanced, the effect of T4 on mitochondrial ATP production was evaluated using specific inhibitor stop assays for mitochondrial phosphate transport and ADP translocator activity. Rats were subjected to 45-min renal ischemia and given normal saline (NS, 0.5 ml) or T4 (20 μg/kg) during the reflow period. By 30-min reflow, the values for apparent endpoint of phosphate transport (PiTm, nmol Pi/mg mitochondrial protein) had recovered to rates seen in nonischemic animals (10.3 ± 0.9) and remained stable at 120 min. T4 treatment did not affect PiTm. In contrast, the apparent endpoint of ADP transport (ADPTm, nmol ADP/mg mitochondrial protein) was dramatically decreased in NS rats at 30-min (6.7 ± 0.5) and 120-min (13.7 ± 1.0) reflow compared with nonischemic control rats (24.7 ± 2.4). T4 significantly improved ADPTm by 30 min (10.1 ± 0.6, P < 0.05). By 120 min T4 stimulated ADPTm (37.7 ± 5.2, P < 0.05) to exceed nonischemic control values. These data suggest the following: 1) postischemic mitochondrial PiTm recovers to control values by 30 min of reflow; 2) T4 does not augment PiTm; 3) renal ischemia causes a dramatic decrease in mitochondrial ADPTm; 4) postischemic T4 significantly enhances mitochondrial nucleotide transport at 30-min reflow; 5) by 120-min reflow, T4 rats have ADPTm which exceeds control values. These findings provide an understanding of at least one of the metabolic components that contribute to the enhanced recovery of cellular ATP resulting from postischemic T4 administration. acute renal failure; mitochondrial transport; cellular adenosine triphosphate recovery Submitted on January 24, 1994 Accepted on November 1, 1994

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Thériault, Josée, Mohsen Agharazzi, Marc Dumont, Vincent Pichette, Denis Ouimet, and Martine Leblanc. "Atheroembolic Renal Failure Requiring Dialysis: Potential for Renal Recovery?" Nephron Clinical Practice 94, no. 1 (November 17, 2004): c11—c18. http://dx.doi.org/10.1159/000070819.

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Basile, David P., Ellen C. Leonard, Alisa G. Beal, Devin Schleuter, and Jessica Friedrich. "Persistent oxidative stress following renal ischemia-reperfusion injury increases ANG II hemodynamic and fibrotic activity." American Journal of Physiology-Renal Physiology 302, no. 11 (June 1, 2012): F1494—F1502. http://dx.doi.org/10.1152/ajprenal.00691.2011.

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ANG II is a potent renal vasoconstrictor and profibrotic factor and its activity is enhanced by oxidative stress. We sought to determine whether renal oxidative stress was persistent following recovery from acute kidney injury (AKI) induced by ischemia-reperfusion (I/R) injury in rats and whether this resulted in increased ANG II sensitivity. Rats were allowed to recover from bilateral renal I/R injury for 5 wk and renal blood flow responses were measured. Post-AKI rats showed significantly enhanced renal vasoconstrictor responses to ANG II relative to sham-operated controls and treatment of AKI rats with apocynin (15 mM, in the drinking water) normalized these responses. Recovery from AKI for 5 wk resulted in sustained oxidant stress as indicated by increased dihydroethidium incorporation in renal tissue slices and was normalized in apocynin-treated rats. Surprisingly, the renal mRNA expression for common NADPH oxidase subunits was not altered in kidneys following recovery from AKI; however, mRNA screening using PCR arrays suggested that post-AKI rats had decreased renal Gpx3 mRNA and an increased expression other prooxidant genes such as lactoperoxidase, myeloperoxidase, and dual oxidase-1. When rats were infused for 7 days with ANG II (100 ng·kg−1·min−1), renal fibrosis was not apparent in sham-operated control rats, but it was enhanced in post-AKI rats. The profibrotic response was significantly attenuated in rats treated with apocynin. These data suggest that there is sustained renal oxidant stress following recovery from AKI that alters both renal hemodynamic and fibrotic responses to ANG II, and may contribute to the transition to chronic kidney disease following AKI.

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Knezevic, Violeta, Tijana Azasevac, Dragana Milijasevic, Uros Milosevic, and Lada Petrovic. "Predictors of renal function non-recovery in critically ill patients with acute kidney injury treated with continuous renal replacement therapy." Srpski arhiv za celokupno lekarstvo, no. 00 (2024): 20. http://dx.doi.org/10.2298/sarh220909020k.

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Introduction/Objective. Acute kidney injury (AKI) is a highly prevalent complication among the critically ill individuals who are admitted to the intensive care unit (ICU). This study deals with identifying the frequency and predictors of the lack of renal function recovery in non-renal functions among critically ill patients requiring dialysis for AKI (AKI-D). Methods. The study included 440 ICU patients from the University Clinical Center of Vojvodina in the period from 2014 to 2018. The patients required Continuous Renal Replacement Therapy (CRRT). In this study, we analyzed various factors including demographic features, clinical characteristics, laboratory parameters, co-morbidities, as well as the need for vasopressor therapy and mechanical ventilation on the day when AKI was confirmed. Additionally, we examined the different modalities of CRRT, which were used. Results. A retrospective analysis of the results included discovered that out of 440 patients with AKI-D, 242 (55%), average age 63.14, did not recover renal function. Significant predictors of renal function non-recovery in critically ill patients with AKI-D were: the patients age over 65 (p = 0.044), starting time of CRRT (p = 0.043), mechanical ventilation (p = 0.044) and previous kidney disease (p = 0.005). Significant predictors of renal function non-recovery in critically ill septic patients with AKI-D were: the patients age over 65 (p = 0.002), diabetes mellitus (p = 0.023), previous kidney disease (p = 0.045), CRP values < 100 mg/l (p = 0.033) and procalcitonin (p = 0.010), while in non-septic patients, the significant predictors of renal function non-recovery includes previous kidney disease (p = 0.035). Conclusion. Out of all examined predictors, both in septic and non-septic patients, previous kidney damage presents the greatest risk for renal function non-recovery in critically ill patients with AKI-D.

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Thadani, Sameer, Dana Y. Fuhrman, Claire Hanson, Joseph A. Carcillo, Poyyapakkam Srivaths, and Ayse Akcan Arikan. "Midterm Renal Outcomes and Renal Recovery in Pediatric Continuous Renal Replacement Therapy." Journal of the American Society of Nephrology 32, no. 10S (October 2021): 132. http://dx.doi.org/10.1681/asn.20213210s1132b.

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Ku, Elaine, Raymond K. Hsu, Kirsten L. Johansen, Charles E. McCulloch, Mark Mitsnefes, Barbara A. Grimes, and Kathleen D. Liu. "Recovery of kidney function after dialysis initiation in children and adults in the US: A retrospective study of United States Renal Data System data." PLOS Medicine 18, no. 2 (February 19, 2021): e1003546. http://dx.doi.org/10.1371/journal.pmed.1003546.

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Background Little is known about factors associated with recovery of kidney function—and return to dialysis independence—or temporal trends in recovery after starting outpatient dialysis in the United States. Understanding the characteristics of individuals who may have the potential to recover kidney function may promote better recognition of such events. The goal of this study was to determine factors associated with recovery of kidney function in children compared with adults starting dialysis in the US. Methods and findings We determined factors associated with recovery of kidney function—defined as survival and discontinuation of dialysis for ≥90-day period—in children versus adults who started maintenance dialysis between 1996 and 2015 according to the United States Renal Data System (USRDS) followed through 2016 in a retrospective cohort study. We also examined temporal trends in recovery rates over the last 2 decades in this cohort. Among 1,968,253 individuals included for study, the mean age was 62.6 ± 15.8 years, and 44% were female. Overall, 4% of adults (83,302/1,953,881) and 4% of children (547/14,372) starting dialysis in the outpatient setting recovered kidney function within 1 year. Among those who recovered, the median time to recovery was 73 days (interquartile range [IQR] 43–131) in adults and 100 days (IQR 56–189) in children. Accounting for the competing risk of death, children were less likely to recover kidney function compared with adults (sub-hazard ratio [sub-HR] 0.81; 95% CI 0.74–0.89, p-value <0.001; point estimates <1 indicating increased risk for a negative outcome). Non-Hispanic black (NHB) adults were less likely to recover compared with non-Hispanic white (NHW) adults, but these racial differences were not observed in children. Of note, a steady increase in the incidence of recovery of kidney function was noted initially in adults and children between 1996 and 2010, but this trend declined thereafter. The diagnoses associated with the highest recovery rates of recovery were acute tubular necrosis (ATN) and acute interstitial nephritis (AIN) in both adults and children, where 25%–40% of patients recovered kidney function depending on the calendar year of dialysis initiation. Limitations to our study include the potential for residual confounding to be present given the observational nature of our data. Conclusions In this study, we observed that discontinuation of outpatient dialysis due to recovery occurred in 4% of patients with end-stage kidney disease (ESKD) and was more common among those with ATN or AIN as the cause of their kidney disease. While recovery rates rose initially, they declined starting in 2010. Additional studies are needed to understand how to best recognize and promote recovery in patients whose potential to discontinue dialysis is high in the outpatient setting.

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Basile, David P., Deborah L. Donohoe, Kelly Roethe, and David L. Mattson. "Chronic renal hypoxia after acute ischemic injury: effects of l-arginine on hypoxia and secondary damage." American Journal of Physiology-Renal Physiology 284, no. 2 (February 1, 2003): F338—F348. http://dx.doi.org/10.1152/ajprenal.00169.2002.

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Ischemic acute renal failure (ARF) results in the permanent loss of peritubular capillaries and predisposes the progression of chronic renal failure. The present study was undertaken to determine whether renal hypoxia, which may represent an important mediator in disease progression, is persistently exacerbated after recovery from ARF. Rats were subjected to ischemia-reperfusion injury and allowed to recover for 5 or 20 wk. Immunohistochemistry of the hypoxia-sensitive marker 2-pimonidizole at 5 wk revealed an overall increase in incorporation in the outer medullary region after recovery from ARF compared with sham-operated controls. Unilateral nephrectomy, in combination with ischemia-reperfusion injury resulted in greater 2-pimonidizole staining than that observed in the bilateral injury model. In addition, in the unilateral ischemia-nephrectomy model, proteinuria, interstitial fibrosis, and renal functional loss developed significantly faster than in the bilateral model of ARF when animals were allowed to recover for 20 wk. l-Arginine in the drinking water (∼0.5 g/day) increased total renal blood flow ∼30%, decreased pimonidizole staining, and attenuated manifestations of chronic renal disease. These data suggest that a reduction in the peritubular capillary density after ARF results in a persistent reduction in renal Po 2 and that hypoxia may play an important role in progression of chronic renal disease after ARF.

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Hennessy, Annemarie, and Ian Hill. "Dialysis for severe hyponatraemia in preeclampsia." Obstetric Medicine 3, no. 1 (March 2010): 38–39. http://dx.doi.org/10.1258/om.2009.090062.

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Severe hyponatraemia is a rare complication of preeclampsia. In the case presented, the rapid recovery of liver function test abnormalities and thrombocytopenia were accompanied by acute renal failure, relative oliguria and progressive hyponatraemia contributing to confusion and ileus. Dialysis was instigated and the patient promptly recovered. Renal function recovered fully.

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Fiorentino, Marco, Fadi A. Tohme, Raghavan Murugan, and John A. Kellum. "Plasma Biomarkers in Predicting Renal Recovery from Acute Kidney Injury in Critically Ill Patients." Blood Purification 48, no. 3 (2019): 253–61. http://dx.doi.org/10.1159/000500423.

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Background: Numerous studies have suggested a possible role for acute kidney injury (AKI) biomarkers in predicting renal recovery both before and after renal replacement therapy (RRT). However, definitions for recovery and whether to include patients dying but free of RRT may influence results. Objectives: To validate plasma neutrophil gelatinase-associated lipocalin (pNGAL) as a useful biomarker for predicting or improving the ability of clinical predictors alone to predict recovery following AKI, including in our model plasma B-type natriuretic peptide (pBNP) to account for cardiovascular events. Methods: We analyzed 69 patients enrolled in the Acute Renal Failure Trial Network study. pNGAL and pBNP were measured on days 2, 7, and 14. We analyzed their predictive ability for subsequent recovery, defined as alive and independent from dialysis in 60 days. In sensitivity analyses, we explored changes in results with alternative definitions of recovery. Results: Twenty-nine patients (42%) recovered from AKI. Neither pNGAL nor pBNP, alone or in combination, was accurate predictors of renal recovery-the best area under the receiver-operating characteristics curve (AUC) was for pNGAL using the largest relative change (AUC 0.59, 95% CI 0.45–0.74). The best clinical model achieved superior performance to biomarkers (AUC 0.69, 95% CI 0.56–0.81). The AUC was greatest (0.75, 95% CI 0.60–0.91) when pNGAL + pBNP on day 14 were added to the clinical model but this increase did not achieve statistical significance. However, integrated discrimination improvement analysis showed that the addition of pNGAL and pBNP on day 14 to the clinical model significantly improved the prediction of renal recovery (p = 0.008). Conclusions: pNGAL and pBNP can improve the accuracy of clinical parameters in predicting AKI recovery and a full model using biomarkers together with age achieved adequate discrimination.

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Basile, David P., Katherine Fredrich, Morufu Alausa, Carlos P. Vio, Mingyu Liang, Mark R. Rieder, Andrew S. Greene, and Allen W. Cowley. "Identification of persistently altered gene expression in the kidney after functional recovery from ischemic acute renal failure." American Journal of Physiology-Renal Physiology 288, no. 5 (May 2005): F953—F963. http://dx.doi.org/10.1152/ajprenal.00329.2004.

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Recovery from ischemic acute renal failure (ARF) involves a well-described regenerative process; however, recovery from ARF also results in a predisposition to a progressive renal disease that is not well understood. This study sought to identify alterations in renal gene expression in postischemic, recovered animals that might play important roles in this progressive disorder. RNA isolated from sham-operated control rats or rats 35 days after recovery from bilateral ischemia-reperfusion (I/R) injury was compared using a cDNA microarray containing ∼2,000 known rat genes. A reference hybridization strategy was utilized to define a 99.9% interval and to identify 16 genes that were persistently altered after recovery from I/R injury (12 were upregulated and 4 were downregulated). Real-time PCR verified the altered expression of six of eight genes that had been positively identified. Several genes that were identified had not previously been evaluated within the context of ARF. S100A4, a specific marker of fibroblasts, was identified in a population of interstitial cells that were present postischemic injury. S100A4-positive cells were also identified in tubular cells at earlier time points postischemia. Genes associated with calcification, including osteopontin and matrix Gla protein, were also enhanced postischemic injury. Several proinflammatory genes were identified, including complement C4, were enhanced in postischemic tissues. Conversely, renal kallikrein expression was specifically reduced in the postischemic kidney. In summary, genes with known inflammatory, remodeling, and vasoactive activities were identified in rat kidneys after recovery from ARF, some of which may play a role in altering long-term renal function after recovery from ARF.

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McAllister, Sophie, Jennifer C. Lai, Timothy P. Copeland, Kirsten L. Johansen, Charles E. McCulloch, Yuenting D. Kwong, Divya Seth, Barbara Grimes, and Elaine Ku. "Renal Recovery and Mortality Risk among Patients with Hepatorenal Syndrome Receiving Chronic Maintenance Dialysis." Kidney360 2, no. 5 (March 3, 2021): 819–27. http://dx.doi.org/10.34067/kid.0005182020.

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BackgroundKidney replacement therapy is controversial for patients with hepatorenal syndrome who may not be liver transplant candidates. Data surrounding the likelihood of recovery of kidney function and mortality after outpatient dialysis initiation in patients with dialysis-requiring hepatorenal syndrome could inform discussions between patients and providers.MethodsWe performed a retrospective cohort study of patients with hepatorenal syndrome who were registered in the United States Renal Data System between 1996 and 2015 (n=7830) as receiving maintenance dialysis. We characterized patients with hepatorenal syndrome by recovery of kidney function using Fine and Gray models. We also examined hazard of recovery of kidney function and death among those with hepatorenal syndrome versus those with acute tubular necrosis (n=48,861) using adjusted Fine–Gray and Cox models, respectively.ResultsOf the patients with hepatorenal syndrome, 11% recovered kidney function. Those with higher likelihood of recovery were younger, non-Hispanic White, and had a history of alcohol use. Compared with patients with acute tubular necrosis, patients with hepatorenal syndrome as the attributed cause of kidney disease had a lower hazard of recovery (HR, 0.22; 95% CI, 0.21 to 0.24) and higher hazard of death within 1 year (HR, 3.10; 95% CI, 2.99 to 3.23) in fully adjusted models.ConclusionsPatients with hepatorenal syndrome receiving chronic maintenance dialysis had a lower likelihood of recovery of kidney function and higher mortality risk compared with patients with acute tubular necrosis. Among patients with hepatorenal syndrome, those most likely to recover kidney function were younger, had a history of alcohol use, and lacked comorbid conditions. These data may inform prognosis and discussions surrounding treatment options when patients with hepatorenal syndrome need chronic maintenance dialysis therapy.

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JC, Montero*. "Renal function during exercise and recovery." Journal of Sports Medicine and Therapy 4, no. 1 (February 1, 2019): 008–15. http://dx.doi.org/10.29328/journal.jsmt.1001037.

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Nair, V., and M. Agraharkar. "Indicators for Recovery of Renal Function." Hemodialysis International 7, no. 1 (February 2003): 73–104. http://dx.doi.org/10.1046/j.1492-7535.2003.01244.x.

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Uchino, Shigehiko. "Choice of therapy and renal recovery." Critical Care Medicine 36, Suppl (April 2008): S238—S242. http://dx.doi.org/10.1097/ccm.0b013e318168e4a8.

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Derweesh, Ithaar H. "Renal functional recovery after radical nephrectomy." BJU International 113, no. 3 (February 14, 2014): 355. http://dx.doi.org/10.1111/bju.12297.

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Quérin, S. "Recovery from “End-Stage” Renal Disease." International Journal of Artificial Organs 19, no. 5 (May 1996): 263–64. http://dx.doi.org/10.1177/039139889601900501.

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Sekkarie, Mohamed A., Friedrich K. Port, Robert A. Wolfe, Kenneth Guire, Raymond Humphrys, George Van Amburg, and C. William Ferguson. "Recovery From End-Stage Renal Disease." American Journal of Kidney Diseases 15, no. 1 (January 1990): 61–65. http://dx.doi.org/10.1016/s0272-6386(12)80593-2.

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Macedo, Etienne, Josee Bouchard, and Ravindra L. Mehta. "Renal recovery following acute kidney injury." Current Opinion in Critical Care 14, no. 6 (December 2008): 660–65. http://dx.doi.org/10.1097/mcc.0b013e328317ee6e.

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Forni, L. G., M. Darmon, M. Ostermann, H. M. Oudemans-van Straaten, V. Pettilä, J. R. Prowle, M. Schetz, and M. Joannidis. "Renal recovery after acute kidney injury." Intensive Care Medicine 43, no. 6 (May 2, 2017): 855–66. http://dx.doi.org/10.1007/s00134-017-4809-x.

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Spurgeon-Pechman, Kimberly R., Deborah L. Donohoe, David L. Mattson, Hayley Lund, Leilani James, and David P. Basile. "Recovery from acute renal failure predisposes hypertension and secondary renal disease in response to elevated sodium." American Journal of Physiology-Renal Physiology 293, no. 1 (July 2007): F269—F278. http://dx.doi.org/10.1152/ajprenal.00279.2006.

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Recovery of renal function is a well-characterized feature of models of acute renal failure; however, more recent studies have reported a predisposition to chronic renal disease. This study sought to determine the susceptibility to sodium-dependent hypertension following recovery from ischemic acute renal failure. Following ischemia-reperfusion (I/R) injury, rats were allowed to recover for 35 days on a 0.4% salt diet, then were switched to 4.0% salt diet for an additional 28 days. Blood pressure was significantly increased in postischemic rats switched to high-sodium diet at day 35 (19 ± 9 mmHg) compared with postischemic rats maintained on low-sodium diet. Plasma renin activity and creatinine clearance were not affected by I/R injury. The ischemic injury combined with transfer to 4.0% salt diet resulted in marked renal hypertrophy characterized by interstitial cellular deposition, tubular dilation, and enhanced rates of albumin excretion. Glomerular structure was altered in post-I/R rats switched to high-sodium diet but not in those maintained on low-sodium diets. When rats were acclimated to high-sodium diet before I/R injury, the early injury was similar to that observed in animals acclimated to low-sodium diet, and these animals progressed rapidly toward chronic kidney disease, as evidenced by advancement of albuminuria. These data suggest that the recovery from acute I/R injury is not complete, compromises Na homeostasis, and predisposes hypertension and secondary renal disease.

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Sharma, Aashish, Marìa Jimena Mucino, and Claudio Ronco. "Renal Functional Reserve and Renal Recovery after Acute Kidney Injury." Nephron Clinical Practice 127, no. 1-4 (September 24, 2014): 94–100. http://dx.doi.org/10.1159/000363721.

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Fenves, Andrew Z., J. Shaun Murphy, and Michael Emmett. "Scleroderma Renal Crisis and Recovery from End-Stage Renal Disease." Seminars in Dialysis 11, no. 3 (October 1, 2007): 189–91. http://dx.doi.org/10.1111/j.1525-139x.1998.tb00332.x.

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ANDO, TADASUKE, HITOSHI OHNO, YUJI HIRATA, AKIO EMOTO, SYUNICHI OGATA, and HIROMITSU MIMATA. "Spontaneous recovery from renal infarction resulting from renal artery dissection." International Journal of Urology 12, no. 4 (April 2005): 405–8. http://dx.doi.org/10.1111/j.1442-2042.2005.01062.x.

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De Francesco Daher, Elizabeth, Dirce Maria T. Zanetta, and Regina C. R. M. Abdulkader. "Pattern of Renal Function Recovery after Leptospirosis Acute Renal Failure." Nephron Clinical Practice 98, no. 1 (November 17, 2004): c8—c14. http://dx.doi.org/10.1159/000079922.

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Kalwar, Sara Rasheed, Naveed Mahar, Murli Lal, Mohsin Mustafa Memon, Harris Hassan Qureshi, and Manzoor Hussain. "Evaluation of predictive factors of renal function recovery in renal failure secondary to urinary tract obstruction." Journal of the Pakistan Medical Association 73, no. 6 (May 15, 2023): 1203–6. http://dx.doi.org/10.47391/jpma.6339.

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Objective: To determine the factors associated with renal function recovery in individuals with kidney failure due to obstruction in the urinary tract. Method: The prospective, descriptive study was conducted July 2020 to August 2021 at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, and comprised adult patients of either gender who had renal failure secondary to obstructive urinary tract. Baseline data regarding patients’ variables, including age, gender, duration of symptoms (25 days or 25 days), haemoglobin (9.85g/dl or 9.85g/dl), serum creatinine and renal cortical thickness (16.5mm or 16.5 mm), was noted on a proforma. The variables were stratified to assess impact on renal recovery. Data was analysed using SPSS 23. Results: Of the 126 patients, 43(34.13%) were males and 83(65.87%) were females. The overall mean age was 44.13±14.18 years. Renal recovery occurred in 67(78.8%) patients having duration of symptoms 25 days, and in 13(31.7%) patients with duration of symptoms 25 days (p 0.001). Renal recovery occurred in 41(58.6%) patients having haemoglobin 9.85g/dL and in 39(69.6%) patients having haemoglobin 9.85g/dL (p=0.2). Renal recovery occurred in 26(37.7%) patients with parenchymal thickness 16.5mm and in 54(94.7%) patients with renal cortical thickness 16.5mm (p 0.001). Conclusion: Symptom duration 25 days, and renal parenchymal thickness 16.5mm were found to be predictive factors of good recovery in renal failure cases secondary to obstructive uropathy. Key Words: Urinary obstruction, Obstructive nephropathy, Percutaneous nephrostomy, Renal failure.

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Lindblad, Anne S., and Karl D. Nolph. "Ambulatory Peritoneal Dialysis: A Study of National Capd Registry Data." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 12, no. 1 (January 1992): 43–47. http://dx.doi.org/10.1177/089686089201200110.

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From January 1981 to July 1988, the U.S. National CAPD Registry followed 23,771 patients on CAPD or CCPD for 3 months or more in 498 participating centers. Of these patients, 281 were deemed to have enough recovery of renal function to do without dialysis for at least 3 months. The median time on PD before recovery was 126 days in 138 patients treated only by PD from the start of dialysis. The median time to recovery in 106 patients was 238 days from the start of any chronic dialysis. A Cox model analysis revealed significantly (p<0.05) increased chances for renal function recovery in patients with systemic immunological diseases with renal involvement (relative risk for recovery [rr]=2.48), patients with renal infarction related to renal vascular occlusion (rr=4.13), and patients >60 years of age compared to a younger group (rr=1.72). However, patients >60 and <21 experienced similar recovery rates. Reduced chances (p<0.05) for recovery were associated with diabetic glomerulosclerosis (rr=0.25) and polycystic kidney disease (rr=0.13). These findings show that renal function recovery rates in chronic hemodialysis and chronic peritoneal dialysis cannot be properly compared unless all risk factors (favoring or against recovery) are balanced, as in a prospective randomized trial.

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Pishko, Allyson Marie, and Gowthami M. Arepally. "Predicting the Temporal Course of Laboratory Abnormality Resolution in Patients with Thrombotic Microangiopathy." Blood 124, no. 21 (December 6, 2014): 4192. http://dx.doi.org/10.1182/blood.v124.21.4192.4192.

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Abstract Background: Screening for deficiency of ADAMTS- 13, a von Willebrand factor-cleaving protease, is commonly performed when there exists a clinical suspicion for thrombotic thrombocytopenic purpura (TTP). The clinical utility of ADAMTS13 testing at presentation has been questioned, as initial treatment decisions are variably influenced by results. Furthermore, current literature remains inconclusive about the differences in response to plasma exchange therapy in patients with severe (<5%) and non-severe (>5%) ADAMTS13 deficiency. Methods: With IRB approval, we performed a single center, retrospective review of patients undergoing plasma exchange therapy at Duke University Medical Center for indication of thrombotic microangiopathy from 2007 through June 2013. We retrospectively identified patients with “severe” deficiency (ADAMTS13² 5%, n=22) and those without severe deficiency (ADAMTS13 >5% or “non-severe” n=22). Cases of TTP associated with bone marrow transplantation, and chemotherapeutic agents were excluded. We trended daily laboratory values for creatinine, platelets, and LDH through completion of TPE . Time to recovery of laboratory abnormalities to normal was noted. We compared the time to resolution of laboratory abnormalities between patients with ADAMTS13² 5% (“severe”) to those with level >5% (“non-severe”). Results: Demographic and clinical information for TTP patients with ADAMTS13<5% and >5% are shown in the Table below. All patients underwent plasma exchange therapy plus steroids after diagnosis with TTP. Patients in both groups were comparable with respect to age and gender, but there were more episodes of recurrent TTP (n=9) in the ADAMTS13 <5% group compared to >5% (n=4). Patients with severe ADAMTS13 deficiency required more TPE (n=19 ) than patients with non-severe ADAMTS13 deficiency (n=13). There were 5 deaths in the non-severe ADAMTS13 cohort as compared to no deaths in the severe ADAMTS13 deficiency. Recovery of platelet count, LDH and Cr level to within normal range are shown for each group within 7, 14 and 21 days of presentation. Recovery of platelet counts for both groups were comparable. No recovery of platelet counts was seen in 3 patients for each group. The majority of patientÕs with and without severe ADAMTS13 deficiency appeared to recover platelet count by day 14 (81% for severe v. 75% for non-severe ADAMTS13 deficiency). Recovery of LDH differed in the two groups. Patients with non-severe ADAMTS13 deficiency were more likely to show no recovery in LDH (38% v. 4% in severe deficiency) or delayed LDH recovery (62% normalized LDH by D21 in non-severe v 95% in severe deficiency). As previously reported, patients with non-severe ADAMTS13 deficiency were more likely to have renal disease and less likely to recover renal function. Few patients in the severe deficiency group presented with abnormal renal function, but in those who had renal dysfunction, the majority (71%) recovered renal function by day 14. Conclusions: Our studies show the temporal resolution of laboratory parameters in patients with severe and non-severe ADAMTS13 deficiency. We show that both groups have similar platelet recovery patterns in response to TPE. However, patients with non-severe ADAMTS13 deficiency have delayed normalization of LDH, higher rates of ESRD and higher mortality. Although additional prospective analysis will need to be performed, this data provides preliminary data showing differing disease pathophysiology of the two groups and that patients with non-severe ADAMTS13 may benefit from alternative/adjunctive therapies to reduce mortality. TableClinical FeaturesADAMTS13 <5%ADAMTS13>5%Total number2222Males (M)/Females (F)7(M)/15(F)9(M)/13(F)Age (mean)4950Recurrent episodes94Mean # TPE1913Deaths05Platelet Count RecoveryTotal number with abnormal plts2221No recovery33*Plts >150K by day ² 713 (59%)9 (45%)Plts>150K by day ² 1418 (82%)15 (75%)Plts >150K by day ² 2121 (86%)15 (75%)LDH normalizationTotal number with elevated LDH2221No recovery1 (5%)8 (38 %)Normal LDH by day ²715(68 %)6 (29%)Normal LDH by day ²1420 (91%)10 (48%)Normal LDH by day ²2121 (95%)13 (62%)Renal function recoveryTotal number with abnormal Cr values at presentation712No recovery+29*Normal Cr by day 73 (42.85%)0Normal Cr by day 145 (71.42%)1 (8.33%)Normal Cr by day 215 (71.42%)3 (16.66%) Disclosures Arepally: TEVA Pharma: Consultancy.

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Manson, Scott R., Robert A. Niederhoff, Keith A. Hruska, and Paul F. Austin. "Endogenous BMP-7 is a critical molecular determinant of the reversibility of obstruction-induced renal injuries." American Journal of Physiology-Renal Physiology 301, no. 6 (December 2011): F1293—F1302. http://dx.doi.org/10.1152/ajprenal.00071.2011.

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Although obstructive uropathies are frequently correctable through surgery, the potential for permanent renal injury remains even following the successful correction of obstructions. Little is known about the intrinsic mechanisms that determine the reversibility of renal injuries. We and others found that exogenous bone morphogenic protein 7 (BMP-7) inhibits the pathogenesis of renal injury. Here, we examine the role of endogenous BMP-7 in the outcome of renal recovery following the correction of obstructive uropathies using a reversible murine model of ureteral obstruction. The role of BMP-7 was determined by examining the regulation of BMP-7 during renal recovery and by treating with either BMP-7-neutralizing antibodies or exogenous BMP-7. While BMP-7 is upregulated following the correction of obstructions that lead to reversible renal injury, the upregulation of BMP-7 is diminished following the correction of prolonged obstructions that lead to irreversible renal injury. The activation of the BMP-7 pathway is required for several processes that contribute to renal recovery including the suppression of transforming growth factor-β-dependent profibrotic pathways, the restoration of renal architecture, and the resolution of fibrotic changes in the kidney. Importantly, the therapeutic restoration of BMP-7 enhances renal recovery following the correction of prolonged obstructions that typically lead to irreversible renal injury. Together, these findings show that, while BMP-7 plays a critical role in the repair of obstruction-induced renal injuries, the potential for renal recovery from prolonged obstruction is diminished, in part, due to the dysregulation of BMP-7. Accordingly, renal recovery from obstructive uropathies may be optimized through timely intervention and adjuvant approaches to restore BMP-7 activity.

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Katz, Ivor J., Lana Sofianou, Omar Butler, and Mark Hopley. "Recovery of Renal Function in Black South African Patients with Malignant Hypertension: Superiority of Continuous Ambulatory Peritoneal Dialysis over Hemodialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 21, no. 6 (November 2001): 581–86. http://dx.doi.org/10.1177/089686080102100608.

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Objective To describe recovery of renal function (RC) in Black South African patients with primary malignant hypertension (MHT) and end-stage renal failure, according to the type of dialysis provided. Design A retrospective analysis of the records of 31 patients with MHT. Setting A university-based, large tertiary-care hospital and its community-based satellite continuous ambulatory peritoneal dialysis (CAPD) clinics. Patients Only patients with renal failure caused by MHT and who were on dialysis between January 1997 and June 2000. There were 11 patients on peritoneal dialysis (PD) that regained renal function; 11 patients on hemodialysis (HD), none of whom recovered renal function; and 9 patients on PD who did not recover renal function during the same time period. Outcome Measures The groups were investigated for variables that might predict RC. Results Peritoneal dialysis compared with HD was highly significant as an indicator of RC ( p < 0.0001), with 60% of patients on PD regaining renal function, versus 0% on HD. Median time to recovery was 300 (150 – 365) days. There was no significant difference in decline of mean arterial pressure (MAP) between the groups; MAP declined significantly in all groups ( p = 0.000 02). All groups received similar drug therapy. In the RC group, initial MAP, kidney size, and urine output tended to be higher and creatinine lower ( p = not significant). Dialysis adequacy was similar in the different groups. Conclusions This retrospective study suggests there may be benefit from PD as the primary form of dialysis when patients have MHT as a cause of their renal failure. Possible predictors of RC include blood pressure control, initial MAP, initial serum creatinine, initial urine output, and kidney size. Time should be allowed for RC before transplantation is undertaken. Prospective studies are needed to confirm the benefit of CAPD in patients with MHT.

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Foley, Robert N., Donal J. Sexton, Scott Reule, Craig Solid, Shu-Cheng Chen, and Allan J. Collins. "End-Stage Renal Disease Attributed to Acute Tubular Necrosis in the United States, 2001-2010." American Journal of Nephrology 41, no. 1 (2015): 1–6. http://dx.doi.org/10.1159/000369832.

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Background/Aims: Though end-stage renal disease (ESRD) is increasingly attributed to acute tubular necrosis (ATN), contemporary trends in the rates of incidence and recovery of renal function are poorly defined. Hence, we set out to describe the clinical epidemiology of ESRD due to ATN between 2001 and 2010. Methods: We examined United States Renal Data System data (n = 1,070,490) for 2001 through 2010 to calculate the incidence rates and rates of renal recovery and death for patients with ESRD due to ATN treated with renal replacement therapy (RRT, n = 27,603). Results: Standardized incidence ratios increased between 2001-2002 and 2009-2010 in the overall population (ratio 2.14), having risen in all demographic subgroups examined. Recovery of renal function was more likely in patients with ATN than in matched controls (cumulative incidence 23% vs. 2% at 12 weeks, 34% vs. 4% at 1 year), as was death (cumulative incidence 38% vs. 27% at 1 year). Hazards ratios for renal recovery increased stepwise with year of RRT inception to 1.34 (95% confidence interval 1.24-1.45) for 2009-2010 (vs. 2001-2002). In contrast, hazards ratios for death declined stepwise to 0.83 (0.79-0.87) in 2009-2010. Conclusion: While the incidence of ESRD attributed to ATN has increased, prospects of renal recovery and survival have also increased. Despite substantial mortality risk on RRT, renal recovery is not a rare occurrence.

Journal articles on the topic 'Renal recovery'

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