End-stage renal disease



What is end-stage renal disease?

End-stage renal disease (ESRD), also called end-stage kidney disease, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys are no longer able to work as they should to meet your body’s needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When your kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up in your body.

With end-stage renal disease, you need dialysis or a kidney transplant to stay alive. But you may also choose to forgo dialysis or transplant and opt for conservative care to manage your symptoms — aiming for the best quality of life possible during your remaining time.

How common is end-stage renal disease?

Please discuss with your doctor for further information.


What are the symptoms of end-stage renal disease?

Early in chronic kidney disease, you may have no signs or symptoms. As chronic kidney disease progresses to end-stage renal disease, signs and symptoms might include:

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Changes in how much you urinate
  • Decreased mental sharpness
  • Muscle twitches and cramps
  • Swelling of feet and ankles
  • Persistent itching
  • Chest pain, if fluid builds up around the lining of the heart
  • Shortness of breath, if fluid builds up in the lungs
  • High blood pressure (hypertension) that’s difficult to control

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes end-stage renal disease?

Many kidney diseases attack the nephrons, the tiny filtering units in the kidneys. This leads to poor blood filtering, which eventually leads to ESRD. ESRD is caused most commonly by diabetes and hypertension (high blood pressure).

If you have diabetes, your body can’t break down glucose (sugar) correctly, so glucose levels in your blood remain high. Having high levels of glucose in your blood damages your nephrons.

If you have hypertension, the increased pressure on the small vessels in your kidneys leads to damage. The damage prevents your blood vessels from performing their blood-filtering duties.

Other causes of ESRD include:

  • Long-term blockage of the urinary tract by kidney stones, enlarged prostate, or certain types of cancer
  • Glomerulonephritis, an inflammation of the filters in your kidney (known as glomeruli)
  • Vesicoureteral reflux, when urine flows into your kidneys
  • Congenital abnormalities

Risk factors

What increases my risk for end-stage renal disease?

There are many risk factors for end-stage renal disease, such as:

  • Diabetes
  • Hypertension
  • Relatives with esrd
  • Polycystic kidney disease (pkd)
  • Alport syndrome
  • Interstitial nephritis
  • Pyelonephritis
  • Certain autoimmune conditions, such as lupus

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is end-stage renal disease diagnosed?

Your doctor diagnoses ESRD using a physical examination and tests to check your kidney function. Kidney function tests include:

  • Urinalysis: This test helps your doctor check for protein and blood in your urine. These substances indicate that your kidneys aren’t processing waste properly.
  • Serum creatinine test: This test helps your doctor check whether creatinine is building up in your blood. Creatinine is a waste product that your kidneys should filter out of your body.
  • Blood urea nitrogen test: This test helps your doctor check how much nitrogen is in your blood.
  • Estimated glomerular filtration rate (GFR): This test allows your doctor to estimate how well your kidneys filter waste.

How is end-stage renal disease treated?

The treatments for ESRD are dialysis or a kidney transplant. In some cases, lifestyle changes and medications may help.


You have two options when you undergo dialysis.

One option is hemodialysis, which uses a machine to process your blood. The machine filters out waste using a solution. It then places the clean blood back into your body. This method is usually used three times per week and takes three to four hours each time.

Your doctor may also prescribe peritoneal dialysis. This process involves placing a solution into your abdomen that’s later removed using a catheter. This type of dialysis can be done at home with proper training. It’s often done overnight while you sleep.

Kidney transplant

Kidney transplant surgery involves removing your affected kidneys (if removal is needed) and placing a functioning donated organ. One healthy kidney is all you need, so donors are often living. They can donate one kidney and continue to function normally with the other.


People with diabetes or hypertension should control their conditions to help prevent ESRD. Both conditions benefit from drug therapy using angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs).

Some vaccines can help prevent serious complications of ESRD. Talk to your doctor about which vaccine may be best for you.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage end-stage renal disease?

The following lifestyles and home remedies might help you cope with end-stage renal disease:

  • Fluid retention can cause rapid weight change, so monitoring your weight is important. You may also need to increase your caloric intake and decrease your protein consumption. A diet low in sodium, potassium, and other electrolytes may be needed, along with fluid restriction.
  • Limit these foods to avoid consuming too much sodium or potassium:
    • Bananas
    • Tomatoes
    • Oranges
    • Chocolate
    • Nuts and peanut butter
    • Spinach
    • Avocadoes
  • Taking vitamin supplements, such as calcium, vitamin C, vitamin D, and iron, can help your kidney function and the absorption of essential nutrients.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: November 9, 2017 | Last Modified: November 9, 2017

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