The following is from an article on renal recovery from AKI.
"Accumulated evidence, mostly derived from observational studies, suggests initial therapy in critically ill patients with AKI with continuous RRT, compared with intermittent modalities, improves the probability of recovery to dialysis independence. Evidence from high-quality randomized trials failed to show any association between delivered dose intensity of RRT and recovery.'
It basically states that dialysis does not reduce the chances of recovery and the amount of dialysis also doesnt reduce recovery. (RRT is renal replacement therapy, or dialysis). So there is really no evidence that dialysis will reduce your chances of recovery. it makes sense to me. Dialysis makes the body healthier than going without it and will give the best chance to heal anything. Going without it only increases stresses in the tissue and reduces the ability to heal. The kidney isnt a muscle. You cant use that analogy. It is however very sensitive to inflammation , toxins and other issues that occur from lack of kidney function. In effect it is a snowball effect. As the kidney fails , it allows build up of chemicals and inflammation that further kills the kidney nephrons. So dialysis is the one chance to reduce this in AKI.
Thanks for the post. I have read these studies and agree. But most of the studies, I believe, are over a short duration of time. Most AKI that is resolved is done so within days to a week or two. My situation is different. It has been nine months. Of course, I now have an ESRD DX (but some kidney function continues to exist). I have been told by two nephro docs to be sure I do not take off too much fluid as it may dry out the kidneys and negatively impact any potential improvement. There must be a reason they do not want that to occur. The other issue is that in most cases if urine was made initially it is greatly reduced or even stops after a year or so on dialysis. What causes that? I don't know, but I go back to my theory of "use it or lose it."
Finally, while I would agree with most all of your points you still have not addressed the fact that there has been improvement in daily creatinine accumulation over the last 90 days (since stopping chemo treatment). As noted in a previous post, my rate of creatinine accumulation in a 24 hour period was previously about 1.5 per period. It is now down to .8 (as we discussed). I see other signs (albeit, small) of improvement, but this is the most significant along with no major accumulation of potassium and phosphorous. I realize I am grasping for straws, but there is hard evidence of improvement and the nephro system is not geared up to move in that direction with me to do what can be done for improvements. It is only watch and wait and I am not convinced that waiting is helping my kidneys.