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What is End-Stage Kidney (Renal) Disease? Print E-mail
Written by Amanda Wattson, MD   
Wednesday, 14 October 2009
 End-stage renal disease (ESRD) is a condition in which there is a permanent and almost complete loss of kidney function. The kidney functions at less than 10% of its normal capacity
What is going on in the body?

Diabetes and high blood pressure are two diseases that cause more than 60% of all cases of end-stage renal disease in the US. Other conditions that can lead to end-stage renal disease include:
- glomerulonephritis, which is swelling and scarring of the filtering part of the kidneys
- polycystic kidneys, an inherited disorder in which cysts enlarge the kidney
- interstitial disease, a swelling of the bladder wall
- obstructive uropathy, or a blockage in the urinary system
- systemic lupus erythematosus, in which there is long-term swelling of the joints, skin, and other organs
- multiple myeloma, a cancer of the bone marrow

In end-stage renal disease, toxins slowly build up in the body. Normal kidneys remove these toxins from the body through urine. The toxins most commonly found are called urea and creatinine. By measuring these waste products in the blood, healthcare providers can tell if the kidneys are functioning normally.
What are the causes and risks of the disease?

The risk of end-stage renal disease is increased for
- older persons
- men
- blacks
- those with a family history of the disease

What are the treatments for the disease?

The treatments for end-stage renal disease include:
- a diet that restricts protein, potassium, and phosphorus
- limited fluid intake
- control of blood pressure by antihypertensive drugs
- control of fluids by diuretics, or "water pills"
- shots of erythropoetin to improve anemia
- use of bicarbonate to improve the pH balance of the blood

Once end-stage renal disease is diagnosed, a person needs to have either dialysis or a kidney transplant. In dialysis, a machine acts as a healthy kidney would, filtering out waste products from the blood or other fluids. Hemodialysis is the process of filtering out toxins from the blood and returning the blood to the body. Peritoneal dialysis removes wastes from the peritoneal cavity, which includes the belly and pelvic areas.
What are the side effects of the treatments?

Side effects vary with the treatment used. All surgery may result in bleeding, infection, and even death. There can be many complications with dialysis, including infections, low blood pressure, and lung and heart problems.
What happens after treatment for the disease?

A person who receives a kidney transplant needs lifelong treatment with immunosuppressants.
These are drugs that keep the body's immune system from attacking the new kidney. Dialysis must be done on a regular schedule. Diet is important for those with kidney failure. A person may be referred to a dietician for advice.
How is the disease monitored?

A kidney specialist will monitor dialysis treatment or any effects after a kidney transplant. Long-term follow-up is very important. A person should see his or her healthcare provider regularly even if there are no symptoms.

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