ArticlePLoS medicine2021
Recovery of kidney function after dialysis initiation in children and adults in the US: A retrospective study of United States Renal Data System data.
Article in PLoS medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Sustained Recovery of Kidney Function in Patients with ESKD under Chronic Dialysis Treatment: Systematic Review and Meta-Analysis.Nutrients · 2023Pooled it
- Safety Net kidney after liver transplantation: unexpected renal recovery in a liver transplant recipient after more than 10 months on maintenance hemodialysis - a case report.Frontiers in nephrology · 2026Article
- Atypical hemolytic uremic syndrome is not always complement mediated: lesson for the clinical nephrologist.Journal of nephrology · 2025Article
- Characterizing Risk Factors for the Need for Kidney Replacement Therapy in Children After Discontinuation of Maintenance Dialysis.Kidney international reports · 2025Article
- A clinical score to predict recovery in end-stage kidney disease due to acute kidney injury.Clinical kidney journal · 2024Article
- Predictors of treatment outcomes in lupus nephritis with severe acute kidney injury and requirement of dialytic support.Clinical rheumatology · 2023Article
- Decision-making about dialysis: Beyond just dialysis or death.Journal of the American Geriatrics Society · 2023Article
- Incidence, Pathogenesis, and Management of Proton Pump Inhibitor-Induced Nephrotoxicity.Drug safety · 2022Review
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Authors and funding
7 authors at 3 institutions in 1 country.
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Abstract
backgroundLittle 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
findingsWe 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.
conclusionsIn 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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