Table of Contents
meaning
End-stage kidney disease (ESKD) is the final stage of long-term (chronic) kidney disease. This is when the kidneys are no longer able to support the body's needs.
End-stage renal disease is also called end-stage renal disease (ESRD).
alias
Renal failure – end stage;renal failure – end stage. ESRD; ESKD
cause
The kidneys remove waste products and excess water from the body. ESRD occurs when the kidneys no longer function at the level needed for daily life.
The most common causes of ESRD in the United States are diabetes and hypertension. These conditions can damage the kidneys.
ESRD most often occurs after chronic kidney disease. The kidneys can slowly stop working over a period of 10 to 20 years before end-stage disease occurs.
symptoms
Common symptoms include:
Other symptoms include:
- Unusually dark or light skin
- changes in nails
- bone pain
- sleepiness and confusion
- Have problems concentrating or thinking
- Numbness in the hands, feet, and other areas
- muscle spasms or spasms
- bad breath
- Bruising easily, nosebleeds, or bloody stools
- excessive thirst
- frequent hiccups
- sexual function problems
- Menstruation stops (amenorrhea)
- sleep problems
- Swelling of the feet and hands (edema)
- Often vomits in the morning
exams and tests
Your health care provider will perform a physical exam and order blood tests. Most people with this condition have high blood pressure.
People with ESRD may produce much less urine than normal, or their kidneys may stop producing urine.
ESRD changes the results of many tests. People receiving dialysis need these and other tests done frequently.
This disease may also change the results of the following tests:
ESRD may require treatment with dialysis or kidney transplantation. You may need to follow a special diet or take medications to help your body function better.
dialysis
Dialysis takes over some of the work of the kidneys when they are no longer functioning properly.
Dialysis allows you to:
- Get rid of excess salt, water, and waste products to prevent them from accumulating in your body.
- Keep minerals and vitamins in the body at safe levels
- helps control blood pressure
- Helps the body produce red blood cells
Your health care provider will discuss dialysis with you before you need it. Dialysis removes waste products from the blood when the kidneys stop working.
- Dialysis is usually given when only 10% to 15% of kidney function remains.
- People waiting for a kidney transplant may also need dialysis while they wait.
Two different methods are used to perform dialysis.
- During hemodialysis, blood is sent through tubes to an artificial kidney or filter. This method can be done at home or at a dialysis center.
- During peritoneal dialysis, a special solution is passed through a catheter tube into your abdomen. The solution remains in the abdomen for a period of time and is then removed. You can do this method at home, at work, or while traveling.
kidney transplant
Kidney transplantation is a surgical procedure in which a healthy kidney is transplanted into a person with kidney failure. Your health care provider will refer you to a transplant center. There, you will be examined and evaluated by the transplant team. They want to see if you are a suitable candidate for a kidney transplant.
special meal
If you have chronic kidney disease, you may need to continue a special diet. Meals may include:
- Limit your total daily protein intake by eating foods low in protein
- Eat enough calories if you are losing weight
- liquid limitations
- Limit salt, potassium, phosphorus, and other electrolytes
Other treatments
Other treatments vary depending on the symptoms, but may include:
- Extra calcium and vitamin D. (Be sure to consult your healthcare provider before taking any supplements.)
- Medicines called phosphate binders prevent phosphorus levels in the blood from getting too high.
- Treatments for anemia include adding iron to your diet, iron pills or injections, injections of a drug called erythropoietin, and blood transfusions.
- Medicines to control blood pressure.
Talk to your doctor about necessary vaccinations, such as:
- COVID-19 vaccine
- Hepatitis A vaccine
- Hepatitis B vaccine
- COVID-19 vaccine
- influenza vaccine
- Pneumonia vaccine (PPV)
Outlook (prognosis)
End-stage kidney disease can lead to death without dialysis or a kidney transplant. Both of these treatments have risks. Results will vary for each person.
Possible complications
Health problems that can result from ESRD include:
References
Inker LA, Levy AS. Staging and management of chronic kidney disease. Authors: Gilbert SJ, Weiner DE, Bombback AS, Perazella MA, Rifkin DE, eds. National Kidney Foundation Primer on Kidney Disease. 8th edition Philadelphia, PA: Elsevier. 2023: Chapter 51.
Tar MW. Classification and management of chronic kidney disease. Authors: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. “Kidney'' by Brenner and Rector. 11th edition Philadelphia, PA: Elsevier. 2020: Chapter 59.
Yeun JY, Young B, Depner TA, Chin AA. Hemodialysis. Authors: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. “Kidney'' by Brenner and Rector. 11th edition Philadelphia, PA: Elsevier. 2020: Chapter 63.
