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Alternative names Return to top
Renal failure - end stage; Kidney failure - end stage; ESRDDefinition Return to top
End-stage kidney disease is a complete or near complete failure of the kidneys to function to excrete wastes, concentrate urine, and regulate electrolytes. Also called End-stage renal disease (ESRD).Causes, incidence, and risk factors Return to top
End-stage kidney disease occurs when the kidneys are no longer able to function at a level that is necessary for day to day life. It usually occurs as chronic renal failure progresses to the point where kidney function is less than 10% of baseline. At this point, the kidney function is so low that without dialysis or kidney transplantation, complications are multiple and severe, and death will occur from accumulation of fluids and waste products in the body.Symptoms Return to top
Signs and tests Return to top
The patient usually has a long history of chronic kidney failure, which has progressed. The person may have required dialysis to control chronic renal failure. The urine volume may decrease or urine production may stop totally. Signs of complications commonly are present.Treatment Return to top
Dialysis or kidney transplantation are the only treatments for ESRD. The physical condition of the person and other factors determines which of these is used for treatment. Other treatments of chronic kidney failure may continue but are ineffective without dialysis or transplantation.
Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, congestive heart failure, urinary tract infections, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated as appropriate.
Blood transfusions and medications such as iron and erythropoietin may be needed to control anemia. Fluids may be restricted to an amount nearly equal to the volume of urine produced.
Dietary restrictions may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Restrictions include low protein in diet, with high carbohydrate levels to make up calories. Salt, potassium, phosphorus, and other electrolytes may be restricted.
Support Groups Return to top
For additional resources, see kidney disease support group.Expectations (prognosis) Return to top
ESRD is fatal unless treated with dialysis or transplantation. Both of these treatments can have serious risks and consequences. The outcome varies and is unique to each individual.Complications Return to top
Calling your health care provider Return to top
Go to the emergency room or call the local emergency number (such as 911) if symptoms indicating end-stage kidney disease have developed. Call your health care provider if known acute or chronic kidney failure persists or worsens.Prevention Return to top
Treatment of chronic kidney failure may delay or prevent progression to ESRD. Some cases may not be preventable. Update Date: 10/17/2003 Updated by: Irfan A. Agha, M.D., Department of Medicine, Renal Division, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |