End stage kidney disease is when a person’s kidneys fail. It occurs in the last stage of chronic kidney disease.
End stage kidney disease (ESKD) is the most advanced stage of chronic kidney disease, which is when a person gradually loses kidney function over time. It can also occur suddenly due to other complications.
The condition is also known as end stage renal disease or kidney failure.
Life expectancy for a person with end stage kidney disease can vary depending on physical factors and treatment. However, according to estimates, the 2-year death rate for patients with ESKD is around
This article discusses the causes, treatments and symptoms of ESKD, as well as ways in which a person can reduce their risk of developing the condition.
There are five stages of kidney disease. ESKD is
The kidneys have an essential role in the body. They filter out waste and excess water from the blood. These waste products come out in a person’s urine.
When a person has ESKD, their kidneys fail to function, either wholly or partially. As a result, waste products can build up in the blood, and this may become life-threatening. A person with ESKD will need kidney dialysis or a kidney transplant.
A buildup of waste products in the blood causes the symptoms of ESKD. The buildup occurs because the kidneys can no longer filter waste products out of the blood sufficiently.
A person with ESKD may experience:
Chronic kidney disease can slowly lead to kidney failure and ESKD, but the kidneys may also stop working suddenly.
If a person suddenly has kidney failure, it is called acute renal failure or acute kidney injury.
Diabetes and high blood pressure are the first and second most common chronic conditions that cause ESKD.
Other chronic conditions that can cause ESKD include:
- lupus and other autoimmune conditions
- genetic conditions originating at birth
- problems with the urinary tract
- nephrotic syndrome, which is a type of kidney disease
Acute renal failure
Acute renal failure or acute kidney injury is when the kidneys stop working suddenly. It
Common causes of acute renal failure include:
ESKD is the most advanced stage of chronic or long-term kidney disease. Chronic kidney disease is estimated to affect around
Several factors increase the risk of chronic kidney disease, including:
In the United States, chronic kidney disease and ESKD
Health inequity plays a role in this disparity. Reviews have highlighted differences in access to healthcare, the financial burden of the United States health care system, and the prevalence of chronic kidney disease risk factors in minority populations as contributing factors.
If a person has chronic kidney disease, the following factors increase the risk it will progress to ESKD:
- not managing diabetes
- not controlling high blood pressure
- drinking too much alcohol
Reduced kidney function may affect many other parts of the body.
Complications of ESKD include:
If a person has symptoms of ESKD, a doctor may test their blood and urine for waste products. These tests may include:
- Glomerular filtration rate (GFR): This tests measures how well the kidneys filter blood.
- Urinalysis: To look for protein and blood in the urine.
- Serum creatinine test: To evaluate the blood for a buildup of the waste product creatine.
- Blood urea nitrogen test: To measure nitrogen levels in the blood.
According to research from 2016, a doctor may diagnose ESKD if a person has uremia. Uremia is when the blood retains large amounts of substances that the kidneys usually remove. If a person has uremia, they will need ongoing kidney dialysis.
A doctor will usually suggest renal replacement therapy for ESKD. Renal replacement therapy includes kidney dialysis or a kidney transplant.
There are two main types of kidney dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis is when a machine filters waste from a person’s blood. This process takes around 4 hours, and people will usually have it done at a dialysis center. A person with ESKD will typically use hemodialysis two or three times each week.
During peritoneal dialysis, a person pumps dialysis fluid into their abdomen. The fluid then draws out waste fluids through the abdomen lining, which is known as the peritoneum. This waste comes out through a catheter to a container which the person then discards. A person can perform peritoneal dialysis at home.
A kidney transplant is when a surgeon replaces the damaged kidney with a healthy one from a donor.
Alongside renal replacement therapy, a doctor may recommend ESKD patients follow a specific diet to support their treatment. The diet may involve:
- avoiding foods high in protein
- eating sufficient calories
- limiting fluid intake
- controlling electrolytes, such as salt, potassium, and phosphorous
The following lifestyle changes may slow the progress of chronic kidney disease, and ESKD:
If a person has the symptoms of chronic kidney disease or ESKD, they should see their doctor. Getting the right treatment as soon as possible may improve their medical outlook.
Without kidney dialysis or a kidney transplant, ESKD is life-threatening. A person with ESKD that requires kidney dialysis will continue to use it long term. A kidney transplant may help them regain normal kidney function.
A person with ESKD’s life expectancy will vary on their treatment and how quickly diagnosis was reached. The average life expectancy of a patient on kidney dialysis is 5–10 years, but people can live for up to 20–30 years with the treatment. Similarly, a patient that receives a full kidney transplant may live for a further 10–20 years after the procedure.
However, according to estimates, the 2-year death rate for patients with ESKD is between
If a person believes they may have chronic kidney disease they should contact a medical professional immediately.