End-Stage Kidney/Renal Disease

The kidneys filter waste and excess water from your blood as urine. Chronic kidney disease causes your kidneys to lose this function over time. End-stage kidney or renal disease is the final stage of chronic kidney disease. It means your kidneys no longer function well enough to meet the needs of daily life.

End-stage kidney disease is also called end-stage renal disease (ESRD). The kidneys of people with ESRD function below 10 percent of their normal ability, which may mean they are barely functioning or not functioning at all.

Kidney disease is generally progressive. The length of each stage varies and depends on how your kidney disease is treated, especially with regard to your diet and whether your treatment includes dialysis. Chronic kidney disease typically doesn’t reach the end stage until several years after you are diagnosed. ESRD is the fifth stage of the progression of chronic kidney disease, which is measured by your glomerular filtration rate (GFR).

Diagnosis and Treatment

ESRD can be diagnosed by checking your kidney function through a series of specific tests.

Urinalysis: This test helps your doctor to 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.

Treatment may include:

  • Hospitalization
  • Administration of intravenous (IV) fluids in large volumes (to replace depleted blood volume)
  • Diuretic therapy or medications (to increase urine output)
  • Close monitoring of important electrolytes such as potassium, sodium and calcium
  • Medications (to control blood pressure)
  • Specific diet requirements

In most cases, patients develop severe electrolyte disturbances and toxic levels of certain waste products, normally eliminated by the kidneys. Patients may also develop fluid overload. Dialysis, diuretic therapy or even kidney transplant may be indicated based on the severity of the cases.