Partial recovery of renal function in patients treated by chronic dialysis
Keywords:
renal function recovery, dialysis, vasculitis, systemic lupus erythematosus, malignant hypertensionAbstract
Introduction. Renal function recovery (RFR), either complete or partial, in hemodialyzed (HD) or peritoneal dialyzed (PD) patients, is observed rather rarely. To a large extent it depends on primary disease leading to end-stage renal disease (ESRD), such as vasculitis, immunological disease associated with renal involvement, and primary malignant hypertension.
Aim. The aim of our study was presentation of three patients with end-stage renal disease (ESRD), needing renal replacement therapy (RRT). After immunosuppressive treatment performed in all patients, recovery of renal function was observed. The RRT was stopped in all patients.
Material and methods. The study was performed in three patients with end-stage renal disease. In two of three described cases the cause of ESRD was p-ANCA or c-ANCA positive vasculitis. In the third one the cause of ESRD was systemic lupus erythematosus (SLE) with renal involvement. In all described cases immunosuppressive therapy was performed parallelly to dialysotherapy. In two patients plasmapheresis was carried out as well.
Results. As a result of applying immunosuppressive treatment, together with renal replacement therapy, we obtained in all patients significant improvement in renal function, enabling us to withdraw them from the renal replacement therapy (RRT): in two cases of the transitional omission of peritoneal dialysotherapy, in one case of permanent ceasing of the treatment with repeatable haemodialyses.
Conclusions. Simultaneous application of chronic dialysis and intensive immunosuppressive treatment in patients suffering from vasculitis or systemic lupus erythematosus may lead to renal function recovery and to possibility to stopping dialysotherapy. In our study we observed renal function recovery more often in PD than in HD patients.
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