Recovery of kidney function after the start of maintenance dialysis can occur, but data on the incidence and risk factors for restarting dialysis after recovery of kidney function in this population are limited.

We conducted a retrospective study of adult Medicare beneficiaries who started dialysis between 2005 and 2015 according to the United States Renal Data System but who had recovery of kidney function (defined as a ≥90-day dialysis-free interval). We identified risk factors that were associated with the risk for the reinitiation of dialysis within a 3-year time frame following the recovery of kidney function and at any time during follow-up using Cox proportional hazards models.

Of the 34,530 individuals previously on dialysis who had recovery of kidney function, 7217 (21%) restarted dialysis (absolute rate of 11.5 per 100 person-years) within 3 years of recovery of kidney function, and 9120 (26%) restarted dialysis during the entire follow-up period (absolute rate of 8.8 per 100 person-years). Among those with CKD stage 1 or 2 after recovery of kidney function, 10% of individuals restarted dialysis within 3 years of their recovery of kidney function, whereas among those with CKD stage 3, 4, or 5, 13%, 27%, and 36% of individuals restarted dialysis within 3 years of recovery of kidney function, respectively. Age at first dialysis, cause of kidney disease, history of CKD or nephrology care prior to starting dialysis, presence of heart failure, CKD stage following recovery of kidney function, and location of first dialysis initiation (inpatient versus outpatient) were some of the risk factors that were strongly associated with the risk of restarting dialysis after the recovery of kidney function.

Over one in five patients with recovery of kidney function after kidney failure restarted dialysis within 3 years.

开始维持性透析后肾功能可能会恢复，但有关该人群肾功能恢复后重新开始透析的发生率和危险因素的数据有限。

我们对根据美国肾脏数据系统在 2005 年至 2015 年间开始透析但肾功能已恢复（定义为≥90 天的无透析间隔）的成年医疗保险受益人进行了回顾性研究。我们使用 Cox 比例风险模型确定了与肾功能恢复后 3 年内以及随访期间任何时间重新开始透析风险相关的风险因素。

在之前接受透析但肾功能恢复的 34,530 人中，7217 人（21%）在肾功能恢复后 3 年内重新开始透析（绝对率为每 100 人年 11.5 人），9120 人（26%）在肾功能恢复后重新开始透析。整个随访期（绝对率为每 100 人年 8.8 例）。在肾功能恢复后的 CKD 1 期或 2 期患者中，10% 的人在肾功能恢复后 3 年内重新开始透析，而在 CKD 3、4 或 5 期患者中，13%、27% 和分别有 36% 的人在肾功能恢复后 3 年内重新开始透析。首次透析时的年龄、肾脏疾病的病因、开始透析前的 CKD 病史或肾脏病护理史、心力衰竭的存在、肾功能恢复后的 CKD 分期以及首次透析开始的地点（住院患者与门诊患者）是一些风险与肾功能恢复后重新开始透析的风险密切相关的因素。

超过五分之一的肾功能衰竭后肾功能恢复的患者在 3 年内重新开始透析。