End-stage renal disease (ESRD), also known as end-stage kidney disease or end-stage renal failure, is a condition when your kidneys are no longer able to do their job of cleansing the blood.
End-stage kidney failure is the advanced stage of chronic impairment in the function of kidneys when they do almost no job, and proper treatment for cleaning the blood becomes mandatory to save your life.
When renal failure occurs, metabolic wastes begin to accumulate along with disturbances in the electrolyte & fluid balance in the body.
How does it feel in end-stage kidney disease?
Kidney diseases progress slowly with deterioration of the kidney tissue. In the beginning, you may not feel any symptoms. However, when chronic renal disease progress to end-stage, it may cause the following symptoms(1):
- Fatigue and muscle weakness
- Nausea and vomiting
- Loss of appetite
- Weight loss
- Bone pain
- Changes in skin color
- Numbness in hands and feet
- Chest pain
- Changes in the pattern of urination
- Swelling on face and eyelids
- Swelling on ankles and feet
- High blood pressure
- Headache and troubled sleep
- Muscle cramps
These symptoms are not specific to end-stage renal failure and may appear in other conditions as well.
What are the causes of ESRD?
ESRD occurs due to progressive damage of nephrons. Nephrons are the small units in the kidneys that perform the function of blood filtration.
Following are the main causes of end-stage renal disease(2).
Diabetes mellitus:
Diabetes causes an elevation in blood glucose as well as increased excretion of glucose in urine. Increased filtration of glucose damages the nephrons, leading to ESRD(3).
High blood pressure:
High blood pressure damages the small blood vessels in your kidneys, reducing their efficiency of filtering the blood. If blood pressure remains chronically elevated, damage to blood vessels advances to an extent causing ESRD.
Glomerulonephritis:
Glomerulonephritis is the inflammation of small blood vessels in your kidneys. If the condition becomes chronic, it can cause end-stage kidney failure.
Urinary obstruction:
Long-term obstruction of the urinary tract also causes end-stage renal failure. Urinary obstruction may arise due to:
- Kidney stones
- Enlarged prostate
- Certain types of tumors, etc.
Which factors increase the risk of ESRD?
The risk of end-stage renal disease is considerably high in individuals suffering from diabetes, hypertension, or glomerulonephritis.
Other factors that increase the risk of ESRD include:
- Tobacco use
- Positive family history of renal diseases
- Older age
Polycystic kidney disease ( a genetic disorder of kidneys characterized by cyst formation in kidneys)
What are the complications of end-stage kidney disease?
End-stage kidney disease disturbs electrolyte and fluid balance. It leads to the following complications:
ESRD causes increased fluid retention in the body leading to the development of edema in the body.
Potassium level increases in the body that affects skeletal muscles and the heart. It can cause cardiac arrhythmias that may prove fatal.
Sex desire may also decrease along with erectile dysfunction.
The immune system becomes weakened, increasing the risk of infections.
Some other less common complications may include:
- Anemia
- Liver failure
- Brain dysfunction
- Seizures
- Stomach and intestinal bleeding, etc.
When to see a doctor?
If you are a diabetic or hypertensive patient or suffering from any other condition that affects your kidneys, you should visit your physician regularly and get your condition evaluated.
If you have symptoms associated with kidney failure, visit your physician immediately to begin the treatment accordingly.
Vascular Health specializes in renal diseases and vascular care. If you have any concerns and are worried about your renal health, book an appointment now!
How is the end-stage renal disease diagnosed?
To diagnose ESRD, your physician will take you thorough medical history.
He will prescribe the following test to confirm the diagnosis and to begin the treatment.
- Blood tests to check elevated levels of metabolic wastes such as urea, creatinine, etc.
- Urine test to check albumin and other proteins in urine
- Ultrasound, MRI, or CT scans to check the condition of your kidneys
- Kidney biopsy to examine the extent of the damage.
What are the treatment options for ESRD?
ESRD can be treated by dialysis or kidney transplant.
End-stage renal disease dialysis is also of two types as follows:
Peritoneal dialysis:
Peritoneal dialysis is a procedure used to filter out wastes from your blood by placing a solution into your abdomen.
Before beginning the procedure, your physician inserts a catheter into your abdominal cavity. Then, dialysis solution is placed into the abdominal cavity with the help of a catheter.
The solution absorbs waste products from the blood and is drained out. This procedure can be performed at home, usually repeated four to six times a day.
Haemodialysis:
Haemodialysis is a procedure that involves the passage of blood outside through a dialysis machine.
A dialysis machine cleans the blood of waste products, and then it’s returned to the body. It is required 2 or 3 times per week and is performed at a dialysis center.
Depending upon the conditions, a normal kidney of a donor can also be transplanted.
References:
- Ren Q, Shi Q, Ma T, Wang J, Li Q, Li X. Quality of life, symptoms, and sleep quality of elderly with end-stage renal disease receiving conservative management: a systematic review. Health Qual Life Outcomes. 2019 May 3;17(1):78.
- Aksoy N, Şelimen D. Investigation of the Causes and Risk Factors of Previous End-Stage Renal Disease in Kidney Transplant Recipients. Transplant Proc. 2020 Feb;52(1):140–5.
- Shen Y, Cai R, Sun J, Dong X, Huang R, Tian S, et al. Diabetes mellitus as a risk factor for incident chronic kidney disease and end-stage renal disease in women compared with men: a systematic review and meta-analysis. Endocrine. 2017 Jan;55(1):66–76.
- Benjamin O, Lappin SL. End-Stage Renal Disease. [Updated 2021 Sep 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499861/
- Murdeshwar HN, Anjum F. Hemodialysis. [Updated 2021 Sep 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563296/
- Centre for Clinical Practice at NICE (UK). Peritoneal Dialysis: Peritoneal Dialysis in the Treatment of Stage 5 Chronic Kidney Disease. London: National Institute for Health and Clinical Excellence (UK); 2011 Jul. (NICE Clinical Guidelines, No. 125.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK92235/
