Renal function recovery (RFR), although rare, in patients on maintenance dialysis has been described as occurring in 1%–5,6% [Chu JK et al, Seminar Dial 2010]. We present three cases of patients affected from vascular nephropathy who recovered renal function after a period of regular haemodialysis.
Table 1. Patient characteristics at start dialysis
Patient
N.1
N.2
N.3
Sex
F
M
Age (years)
68
73
41
Diagnosis
RA trombosis
LA stenosi (70%)
RA infarction
Trombotic microangiopathy
Comorbidity
MD, DV, S
DV
HF
Pre-exiting CKD
No
Diuresis (mL)
200-700
300
500
RA, right artery; LA, left artery; CKD, chronic kidney disease; MD, mellitus diabetes; DV, diffuse vasculopathy ; HF, hypertensive familiarity
Patient N.1 was taken off from haemodialysis after 6.5 months, patient 2 and 3 after 3.5 and 11.5 months, respectively. We observed a progressive increase of urinary output which reflected an improvement of renal function. Urinary urea and glomerular filtrate rate increased (Figure 1) and all three patients withdraw haemodialysis treatment.
Our experience shows that recovery of renal function in renovascular diseases is possible even after regular haemodialysis treatment. An increase of urine volume could be the first clinical sign of renal function recovery. Clinical and laboratory close monitoring allows to take the decision to withdraw dialysis therapy. Reviewing our Dialysis Centre data and Italian Registry data could clarify clinical and laboratory characteristics of this subgroup of patients and it could identify the predictor factors of renal function recovery in Italian population.
