PREDICTORS OF RENAL RECOVERY IN AUSTRALIAN AND NEW ZEALAND END-STAGE RENAL FAILURE PATIENTS TREATED WITH PERITONEAL DIALYSIS

1 Australia and New Zealand Dialysis and Transplant Registry, Adelaide; 2 Department of Renal Medicine, Princess Alexandra Hospital, Brisbane; 3 Department of Nephrology and Transplantation Services, the Queen Elizabeth Hospital, and University of Adelaide, Adelaide, Australia; 4 Renal Department, Middlemore Hospital, Otahuhu, Auckland, New Zealand; 5 Department of Nephrology, Monash Medical Center, Clayton, Victoria, Australia Correspondence to: D. Johnson, Department of Renal Medicine, Level 2, Ambulatory Renal and Transplant Services Building, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia. david_johnson{at}health.qld.gov.au Objectives : The aim of this study was to investigate the factors affecting recovery and durability of dialysis-independent renal function following commencement of peritoneal dialysis (PD). Design : Retrospective, observational cohort study of the Australian and New Zealand PD patient population. Setting : Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Participants : The study reviewed all patients in Australia and New Zealand who commenced PD for treatment of end-stage renal failure between 15 May 1963 and 31 December 2004. Main Outcome Measures : The primary outcomes examined were recovery of dialysis-independent renal function and time from PD commencement to recovery of renal function. A secondary outcome measure was time to renal death (patient death or recommencement of renal replacement therapy) following recovery of dialysis-independent renal function. Results : 24663 patients commenced PD during the study period. Of these, 253 (1%) recovered dialysis-independent renal function. An increased likelihood of recovery was predicted by autoimmune renal disease, hemolytic-uremic syndrome, paraproteinemia, cortical necrosis, renovascular disease, and treatment in New Zealand. A reduced likelihood of recovery was associated with polycystic kidney disease and indigenous race. Analysis of a contemporary subset of 14743 patients in whom complete data were available for body mass index, smoking, and comorbidities yielded comparable results, except that increasing age was additionally associated with a decreased likelihood of recovery. Of the 253 patients who recovered renal function, 151 (60%) recommenced renal replacement therapy and 49 (19%) died within a median period of 226 days (interquartile range 110-581 days). The only significant predictors of continued rena