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End-Stage Renal Disease (ESRD)

Overview

End-stage renal disease (ESRD) represents the final stage of chronic kidney disease (CKD). In ESRD, the kidneys can no longer work well enough to maintain body health. Patients usually require renal replacement therapies, such as dialysis or pre-emptive kidney transplantation.

ESRD may present with:

  • Fluid overload that can cause swelling in the legs, face, or abdomen, and make breathing difficult.
  • Uremic gastritis symptoms, such as indigestion, acidity, loss of appetite, and itching.
  • Neurological issues, such as confusion, drowsiness, or unusual behaviour caused by uraemic toxins affecting the brain.
  • Metabolic problems, including high potassium (hyperkalaemia) and an imbalance in the body’s acid levels (metabolic acidosis).

ESRD usually occurs when long-term conditions, such as diabetes, hypertension, or chronic kidney disorders have severely damaged the kidneys over time.

The following investigations are commonly used to assess and monitor ESRD:

  • Urine tests and blood tests to assess renal function
  • Ultrasound (USG) for kidney imaging and evaluation.

Management of ESRD focuses on replacing lost kidney function and maintaining overall health through appropriate therapies, including the following:

  • Haemodialysis or peritoneal dialysis for removing waste and extra fluid when the kidneys can no longer do so.
  • Kidney transplantation for replacing the failed kidney with a healthy one. It can be done before or after starting dialysis.

You should consult a doctor or kidney specialist if you experience:

  • Swelling in the legs, feet, or around the eyes
  • Shortness of breath or difficulty breathing
  • Reduced urine output or changes in urine colour
  • Persistent nausea, vomiting, or fatigue
  • High blood pressure that is hard to control
  • Signs of infection such as fever or chills

Though ESRD itself cannot be prevented, one can take steps to reduce the risk or slow down the progression of kidney disease. These steps include:

  • Managing chronic conditions such as diabetes and high blood pressure
  • Avoiding overuse of medications that can harm the kidneys
  • Staying well hydrated and maintaining a healthy lifestyle
  • Undergoing regular check-ups to monitor kidney function

Patients with ESRD should consult a nephrologist (kidney specialist) for optimal management and treatment.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.