Recovery of Renal Function in a Kidney Transplant Patient After Receiving Hemodialysis for 4 Months

Renal transplant is the preferred choice of treatment for end-stage renal diseases. To avoid rejection, increasingly potent immunosuppressants are administered to recipients of kidney transplants. Complications, when there is excess immunosuppression, include possible lethal infections, which reduce allograft survival and compromise patient survival. When there is insufficient immunosuppression, rejections could impair allograft outcomes. Moreover, recurrent primary diseases could also threaten allograft outcomes. Here, we report a case of a patient who underwent ABO-incompatible and living-related renal transplant in which the patient experienced 7 acute kidney injury episodes, including recurrent malignant hypertension, rejection, and infections. After the patient underwent 4 months of hemodialysis (with serum creatinine level of 17 mg/dL), which was later terminated, no adverse effects were found for 1 year (serum creatinine level of 3.7 mg/dL). Therefore, renal function recovery may be longer in patients with renovascular diseases with hypertension. For recipients undergoing hemodialysis with allograft failure, we suggest that the treatment should be not completely withdrawn of immunosuppressants so that acute kidney injuries are minimized. Even after prolonged hemodialysis (eg, for 4 months), recipients may still be able to recover renal function.