#3957 SUSTAINED RECOVERY OF KIDNEY FUNCTION IN PATIENTS WITH ESKD UNDER CHRONIC DIALYSIS TREATMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Abstract Background and Aims The prevalence of recovery of kidney function (RKF) in patients under maintenance dialysis is poorly defined mainly because of different definitions of RKF. The accurate assessment of sustained RKF is critical because the survival and quality of life of patients treated by maintenance dialysis are dramatically poor as compared to patients under conservative treatment. The sustained withdrawal of chronic dialysis has moreover a significant social and economic impact, considering the high burden of dialysis on health resources. Method Therefore, to gain more insights into the epidemiology of RKF, we performed a systematic review and meta-analysis of studies addressing the prevalence of sustained (at least for 30 days) RKF in patients under maintenance dialysis. Acute kidney injury (AKI) and RKF in the first 90 days of dialysis were the main exclusion criteria. Results Overall, 7 studies (10 cohorts) including 2,444,943 chronic dialysis patients (range: 430-1,900,595 patients) were meta-analyzed. The period of observation ranged from 4 to 43 years. The prevalence of RKF was 1.49% (95% C.I.:1.05-2.11; p<0.001] with high heterogeneity I2: 99.8%, P<0.001 (Figure 1). The weighted mean dialysis vintage before RKF was 294±165 days; RKF persisted for a weighted mean of 27.5 months. The percentage of RKF was higher in studies from the U.S. (1.96% [95% C.I.: 1.24-3.07]) as compared to other countries (1.04% [95%C.I.: 0.66-1.62]; P = 0.049). Conclusion In conclusion, sustained RKF unrelated to AKI occurs in about 1.5% of patients under maintenance dialysis. On average, RKF patients discontinue chronic dialysis about ten months after starting treatment and live free of dialysis for more than two years. The higher prevalence of RKF reported in the U.S. versus other countries suggests a major role of country-specific policies for dialysis start.