End-Stage Renal Disease


Learn About End-Stage Renal Disease
and Your Treatment Options

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More than 600,000 Americans have end-stage renal disease due to chronic problems with their kidneys.

When kidney functions are affected, it’s often a gradual process that slowly progresses over time. If kidney problems are detected early, as may be the case during a more detailed urological exam, efforts can be made to maintain optimal kidney functions.

  • While early treatments that typically involve medication can be successful, there are times when kidneys become severely impaired.
  • This is referred to as end-stage renal disease, a condition typically defined as kidney functioning that’s around 10 percent of what’s considered normal.

Signs of End-Stage Renal Disease

Early signs of kidney disease are usually vague in nature, meaning there are many possible sources. For instance, a patient may have a severe urinary tract infection that’s causing frequent urination. Part of the reason for the vague nature of symptoms is the ability of kidneys to adapt and remain functional even when there are issues slowing down this process. Signs and symptoms that may suggest end-stage renal disease include:

  • General fatigue and weakness
  • Nausea and vomiting
  • High blood pressure that’s difficult to control
  • Loss of appetite for no apparent reason
  • Changes in mental clarity and focus
  • Muscle cramps
  • Swollen feet and/or ankles
  • Persistent itching



Diagnosis and Patient Assessment

If kidney disease is suspected, one way to measure kidney functioning is by looking at a patient’s glomerular filtration rate (GFR). GFR is usually determined with a blood creatinine test. Lower levels of GFR suggest a reduction in kidney functions. Diagnosis of end-stage renal disease can also involve blood and urine tests, a CT scan or ultrasound to look at the structure of kidneys, and a biopsy to assess damage.

Treatment Options with Kidney Failure

By the time a patient has end-stage renal disease, there will be two main treatment options. Some patients prefer to undergo regular dialysis treatments to filter blood and reduce the levels of harmful waste in the body. There are two forms of dialysis. With hemodialysis, blood is filtered outside of the body. With peritoneal dialysis, a special type of fluid is placed into the abdomen to absorb waste through small blood vessels in this area.

Other individuals with late-stage kidney disease choose to have a kidney transplant. With a transplant, a donor kidney must be a good match to reduce the risk of rejection. In some situations, a living donor such as a family member or friend may be able to donate a kidney, since it’s possible to live with one functioning kidney. The average waiting time for a donor kidney is 3-5 years.

Causes and Contributing Factors

Chronic kidney disease that can lead to end-stage renal disease is sometimes related to underlying health issues, including diabetes, chronic high blood pressure, and various kidney diseases and infections. Long-term use of certain medications, particularly NSAIDs, may be another contributing factor. Kidney failure is more likely to occur in older adults, although anyone with persistent kidney problems may be affected.

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