End-stage Renal Disease

As chronic kidney disease—the progressive loss of kidney function—reaches an advanced stage, it results in end-stage renal disease, commonly known as end-stage kidney disease or kidney failure. Your kidneys no longer function as they should to support your body's demands if you have end-stage renal disease.

Wastes and extra fluid are removed from the circulation by your kidneys and expelled in the urine. Dangerous concentrations of fluid, electrolytes, and toxins can accumulate in your body when your kidneys lose their filtering capacity.

You require dialysis or a kidney transplant to survive if you have end-stage renal disease. For the highest quality of life in your remaining time, you might alternatively decide to select conservative treatment to control your symptoms.

End-stage Renal Disease: Causes

When kidney function is hampered by a condition or illness, kidney damage develops over months or years. This is known as renal disease. Even if the underlying illness is treated, kidney damage might still worsen in some patients.

Kidney illness is brought on by several ailments and disorders, including −

  • Diabetes type 1 or type 2

  • Elevated blood pressure

  • Inflammation of the kidney's filtration organs is known as glomerulonephritis (glomeruli)

  • Inflammation of the kidney's tubules and surrounding tissues is known as interstitial nephritis.

  • Other hereditary kidney illnesses, such as polycystic kidney disease

  • persistent blockage of the urinary system caused by diseases including an enlarged prostate, kidney stones, or certain malignancies

  • The disorder is known as vesicoureteral reflux, which causes urine to back up into the kidneys

  • Pyelonephritis, another name for recurrent kidney infection

End-stage Renal Disease: Symptoms

Early on in chronic kidney disease, you may not exhibit any symptoms or indicators. Signs and symptoms that chronic kidney disease is developing into end-stage renal disease include −

  • Nausea

  • Vomiting

  • Reduced appetite

  • Weakness and weary

  • Changes in your urination frequency

  • If fluid accumulates around the heart's lining, chest discomfort may result.

  • Breathlessness if pulmonary fluid accumulates

  • Swelling in the ankles and feet

  • Hard to regulate high blood pressure (hypertension)

  • Headaches

  • Trouble sleeping

  • Reduced mental clarity

  • Spasms and twitches in the muscles

  • Constant itching Taste of metal

While kidney disease symptoms and signs are frequently ambiguous, they can also be brought on by other ailments. Signs and symptoms might not develop until permanent damage has taken place since your kidneys can compensate for diminished function.

When to Visit a Doctor?

If you have any signs or symptoms of renal disease, schedule a visit with your doctor.

Your healthcare provider will probably evaluate your kidney function with urine and blood tests as well as your blood pressure during routine office visits if you have a medical condition that raises your risk of renal disease. Find out from your provider if you need to undergo these tests.

End-stage Renal Disease: Risk Factors

There is a chance that chronic kidney disease will advance more quickly to end-stage renal disease due to several circumstances, including −

  • Poorly managed diabetes with blood sugar

  • Glomeruli-related kidney disease damages the kidney structures responsible for removing waste products from circulation.

  • Renal polycystic disease

  • Elevated blood pressure

  • Nicotine usage

  • American Indian, Asian, African-American, Hispanic, or another ancestry

  • The renal disease runs in the family

  • Greater age

  • Frequent use of drugs that might harm the kidney

End-stage Renal Disease: Diagnosis

The diagnosis of end-stage renal disease is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes.

Your medical professional could inquire about your personal and family medical history to identify end-stage renal disease. You could also undergo physical and neurological examinations, in addition to additional testing like −

  • Blood tests to determine the level of waste products in your blood, such as urea and creatinine

  • Testing your urine for the presence of the protein albumin

  • To evaluate your kidneys and search for atypical regions, imaging tests such as an ultrasound, MRI, or CT scan may be used.

  • The removal of a sample of kidney tissue (biopsy), is then examined under a microscope to determine the type of kidney disease you have and the extent of the damage there is.

To monitor the development of your kidney, your doctor may repeat several tests over time.

End-stage Renal Disease: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

When your kidneys are unable to perform some of their functions on their own, dialysis takes over. As part of this, surplus fluids and waste items are eliminated from the blood, electrolyte levels are replenished, and blood pressure is managed.

Hemodialysis and peritoneal dialysis are two types of dialysis available.

Dialysis of the Abdomen

With the aid of a fluid that washes in and out of the peritoneal space, blood vessels in your abdominal lining (peritoneum) substitute for your kidneys during peritoneal dialysis. You receive peritoneal dialysis at home.

Hemodialysis is a procedure where a machine filters salts, fluid, and toxic waste from your blood to partially replace the function of your kidneys. Hemodialysis can be performed at home or in a facility.

Surgical Treatment

In a kidney transplant, a healthy kidney from a living or deceased donor is surgically implanted into a patient whose kidneys are no longer functioning correctly. When it comes to treating end-stage renal illness, a kidney transplant is frequently referred to as a lifetime of dialysis.

End-stage Renal Disease: Prevention

Some of the measures that can help to prevent end-stage renal disease include −

  • Get and keep a healthy weight.

  • Exercise often

  • Have a balanced diet of nutrient-rich, low-sodium meals while cutting back on protein.

  • Your blood pressure is under control

  • The recommended dosage of your drugs.

  • Every year, have your cholesterol levels tested.

  • Maintain a healthy blood sugar level.

  • Avoid using tobacco products or smoking.

  • Get routine examinations


After receiving a diagnosis of end-stage renal illness, a large percentage of patients will need dialysis, and a lucky few may qualify for a kidney transplant. Sadly, end-stage renal disease considerably raises mortality and morbidity while also adding a tremendous financial burden to the healthcare system. Hence, the illness is best addressed by an interdisciplinary team committed to effective disease management and enhancing patient outcomes.

End-stage renal illness has no known cure, and the only therapies offered are temporary. So, stopping the disease's development is essential to enhancing long-term results.

A dedicated interprofessional healthcare team should include a nurse educator, a skilled nephrologist, a specialist pharmacist, a nutritionist, a social worker, and a few clinical practitioners.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 28-Apr-2023


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