End-Stage Kidney Disease - End-Stage Renal Disease

End-stage renal disease (ESRD) is a condition in which there is a permanent and almost complete loss of kidney function. The kidney functions at less than 10% of its normal capacity

What is going on in the body?

Diabetes and high blood pressure are two diseases that cause more than 60% of all cases of end-stage renal disease in the US. Other conditions that can lead to end-stage renal disease include:

In end-stage renal disease, toxins slowly build up in the body. Normal kidneys remove these toxins from the body through urine. The toxins most commonly found are called urea and creatinine. By measuring these waste products in the blood, healthcare providers can tell if the kidneys are functioning normally.

What are the causes and risks of the disease?

The risk of end-stage renal disease is increased for

What are the signs and symptoms of the disease?

The symptoms that are caused by the the toxic buildup of waste products incude:

How is the disease diagnosed?

The disease is diagnosed by a careful look at a person's medical history and through blood tests. Many people with end-stage renal disease are also malnourished. Blood samples will be taken to check the levels of creatinine and urea. In many cases, there is a low level of the kidney hormone erythropoetin. The blood tests may also show high levels of potassium, phosphorus, parathyroid hormone, and magnesium as well as low levels of calcium.

An ultrasound of the kidneys may show small, scarred kidneys. A kidney biopsy, in which a small sample of kidney tissue is taken, may show how much damage has been done to the kidneys.

What can be done to prevent the disease?

End-stage renal disease can be prevented by controlling high blood pressure. Also, keeping blood sugar levels in tight control for people with diabetes can help prevent the problem.

ACE inhibitor medications, such as lisinopril or enalapril, can be used to control high blood pressure. These drugs are also used to lower the amount of protein in the urine. These drugs can slow the rate of kidney failure.

What are the long-term effects of the disease?

The long-term effects of end-stage renal disease include:

What are the treatments for the disease?

The treatments for end-stage renal disease include:

Once end-stage renal disease is diagnosed, a person needs to have either dialysis or a kidney transplant. In dialysis, a machine acts as a healthy kidney would, filtering out waste products from the blood or other fluids. Hemodialysis is the process of filtering out toxins from the blood and returning the blood to the body. Peritoneal dialysis removes wastes from the peritoneal cavity, which includes the belly and pelvic areas.

What are the side effects of the treatments?

Side effects vary with the treatment used. All surgery may result in bleeding, infection, and even death. There can be many complications with dialysis, including infections, low blood pressure, and lung and heart problems.

What happens after treatment for the disease?

A person who receives a kidney transplant needs lifelong treatment with immunosuppressants. These are drugs that keep the body's immune system from attacking the new kidney. Dialysis must be done on a regular schedule. Diet is important for those with kidney failure. A person may be referred to a dietician for advice.

How is the disease monitored?

A kidney specialist will monitor dialysis treatment or any effects after a kidney transplant. Long-term follow-up is very important. A person should see his or her healthcare provider regularly even if there are no symptoms.

Author:Rajnish K. Dhingra, MD
Date Written:
Editor:Smith, Mary Ellen, BS
Edit Date:05/24/00
Reviewer:Barbara Mallari, RN, BSN, PHN
Date Reviewed:05/04/01