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Conditions InDepth: End-stage Renal Disease (ESRD)

ESRD is the last stage of chronic kidney disease (CKD). It means the kidneys are no longer able to do their job. Dialysis or a kidney transplant will be needed to keep living.

The kidneys sit in the rear side of the lower back. One sits on each side of the spine. The kidneys pull waste and other material from the blood and pass it out of the body as urine. This not only helps to clean the blood, but also balances acids and fluids. The kidneys can play an important role in controlling blood pressure. Waste, fluids, and other elements can build up in the body if the kidneys are not working well enough. This affects the body's ability to work including increased strain on the heart. Within a couple of weeks the changes can be fatal.

Anatomy of the Kidney

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The filters in the kidneys can be damaged from 1 injury or repeated damage over a long period of time. Poisoning, severe injury, or sudden intense loss of blood flow can cause sudden loss of healthy kidney tissue. This may make them stop working as they should. However, most kidney disease builds over many years. Long-term illnesses like diabetes and high blood pressure damage filters in the kidneys. The damage builds over time with little to no symptoms until the damage is severe.

The loss of kidney function in ESRD can cause a number of symptoms throughout the body. Problems may include pain, problems with blood cells, high blood pressure, bone problems, heart disease, and fluid buildup.

REFERENCES:

Choosing a treatment for kidney failure. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment. Updated January 2018. Accessed July 19, 2019.

Chronic kidney disease (CKD) in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/chronic-kidney-disease-ckd-in-adults. Updated January 18, 2019. Accessed July 19, 2019.

Complications of chronic kidney disease. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/complications-of-chronic-kidney-disease. Updated February 8, 2019. Accessed July 19, 2019.

Murphree DD, Thelen SM. Chronic kidney disease in primary care. J Am Board Fam Med. 2010;23(4):542-550.

O'Connor NR, Corcoran AM. End-stage renal disease: symptom management and advance care planning. Am Fam Physician. 2012;85(7):705-710.

What is kidney failure? National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/KidneyFailure. Accessed July 19, 2019.

Last reviewed July 2019 by EBSCO Medical Review Board Adrienne Carmack, MD  Last Updated: 10/4/2019