End-stage kidney disease is the complete, or almost complete failure of the kidneys to function. The kidneys can no longer remove wastes, concentrate urine, and regulate many other important body functions.
End-stage kidney disease occurs when the kidneys are no longer able to function at a level needed for day-to-day life. It usually occurs when chronic kidney disease has worsened to the point at which kidney function is less than 10% of normal.
ESRD almost always follows chronic kidney disease. A person may have gradual worsening of kidney function for 10 - 20 years or more before progressing to ESRD.
Patients who have reached this stage need dialysis or a kidney transplant.
The most common causes of ESRD in the U.S. are diabetes and high blood pressure. See Chronic kidney disease for a complete list of causes.
Symptoms may include:
Other symptoms may develop, including:
The urine volume may decrease or urine production may stop. The patient will usually have signs of the many complications of chronic kidney disease.
End-stage kidney disease changes the results of many tests. Patients receiving dialysis will need these and other tests done often:
This disease may also change the results of the following tests:
Dialysis or kidney transplantation is the only treatment for ESRD. Your physical condition and other factors determine which treatment is used.
When you start dialysis depends on different factors, including your lab test results, severity of symptoms, and readiness. You should begin to prepare for dialysis before it is absolutely necessary. The preparation includes learning about dialysis and the types of dialysis therapies, and placement of a dialysis access.
See also: Dialysis
Treatment usually includes an ACE inhibitor, angiotensin receptor blocker, or other medications for high blood pressure.
You may need to make changes in your diet.
See Diet and chronic kidney disease for more detail.
Other treatments may include:
Different treatments are available for problems with sleep or restless leg syndrome.
Patients with chronic kidney disease should be up-to-date on important vaccinations, including:
For additional resources, see kidney disease support group.
Without dialysis or a kidney transplant, death will occur from the buildup of fluids and waste products in the body. Both of these treatments can have serious risks and consequences. The outcome is different for each person.
Treatment of chronic kidney disease may delay or prevent progression to ESRD. Some cases may not be preventable.
Renal failure - end stage; Kidney failure - end stage; ESRD