End-stage renal disease is kidney failure, the last stage of chronic kidney disease. Kidney disease is can be caused by an underlying health problem, often diabetes or high blood pressure. When the kidneys can no longer filter the blood of waste and extra fluid, you need dialysis or a kidney transplant to survive.
End-stage kidney disease (ESKD), or kidney failure, is the fifth and final stage of chronic kidney disease (CKD) progression. With chronic kidney disease, your kidneys can’t do their day-to-day job. When they fail, you need treatment either dialysis or a kidney transplant to survive.
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The kidneys are bean-shaped organs, located deep inside the body toward the back, down near the hips. Most people have two kidneys. But some people are born with only one kidney, or only one that works. Other people have a single kidney because they donated one or had one removed for another health reason. In most cases, one kidney can still do everything your body needs.
Kidney disease is caused by many different health problems that can damage the kidneys. The damage can take place all at once or a little bit at a time over many years. Eventually, kidney disease can lead to kidney failure.
Common causes of kidney disease include:
Early kidney disease often has no symptoms. Some people may not even know they have kidney disease until their kidneys fail.
If your kidneys begin to fail, you may experience:
If you develop any of these symptoms, you should contact a healthcare provider immediately.
End-stage renal failure can cause complications and emergencies that require treatment, including:
People with chronic kidney disease usually see a kidney specialist called a nephrologist. This healthcare provider takes blood tests at a set schedule to measure levels of:
Your healthcare provider will calculate a special score called the estimated glomerular filtration rate, or eGFR. This score helps the provider track the severity of kidney disease over time. It starts at 100 (highest kidney function) and goes down to 0 (no kidney function). A score below 15 marks kidney failure and the need for dialysis or kidney transplant.
Healthcare providers determine the filtration rate based on your:
Dialysis takes over the work of the kidneys to keep your body in balance. It has no effect on kidney function. There are two common types:
You can receive dialysis in a hospital, in a dialysis clinic or at home. Your healthcare provider will help you decide which option is best for you.
Usually, each hemodialysis treatment lasts about four hours. Most people receiving hemodialysis need it three times a week. A peritoneal dialysis treatment takes 30 to 40 minutes and should get done several times a day.
Your nephrologist will determine what type of dialysis you need based on:
A person waiting for a kidney transplant needs dialysis treatments right up to the time of surgery.
A kidney transplant is an operation where surgeons replace the diseased kidney with a new one placed in the groin area. The kidney can come from someone who has died or from a living donor. Remember, most people have two kidneys and can live just fine with one healthy kidney.
Your healthcare team will perform tests to determine if the donor kidney is a good match. To prevent your body from rejecting a new kidney, you will need to take special drugs. These drugs are called anti-rejection medications or immunosuppressants.
After a successful transplant, the donated kidney will start filtering blood and removing waste.
The best way to prevent end-stage renal disease is to manage the disease harming your kidneys, especially high blood pressure or diabetes. Doing so will limit the amount of damage done to your kidneys.
Healthcare providers can’t cure kidney failure, and the disease is life-threatening. But dialysis or a kidney transplant can help you live longer and manage any symptoms or complications. You can also do the things you enjoy.
People with severe kidney disease (even those on dialysis) should:
A dietician can help you plan proper nutrition for kidney disease.
Many people with kidney failure keep working. It may make you feel more normal and productive. And it can provide insurance to cover your health costs.
Your healthcare providers can help you plan a treatment schedule that fits your work needs. You can even ask your healthcare provider for a social worker to help you talk with your employer. For example, if you’re on peritoneal dialysis and do it yourself, you’ll need access to a clean place at work. If you’re on hemodialysis, your employer should know that you can’t lift heavy things.
If you can’t work, government and private programs can help. They can provide money, health insurance and transportation to doctors’ appointments and treatments. A social worker can help you find such programs and apply.
A note from Cleveland Clinic
End-stage renal disease is the last stage of chronic kidney disease. It marks the point when kidney function drops to very low levels. Kidney failure failure is life threatening, but dialysis or transplantation can relieve weakened kidneys. If you have kidney disease, a healthcare provider can help you manage the cause and watch your kidney function.
Last reviewed by a Cleveland Clinic medical professional on 11/13/2020.
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