End-stage kidney disease (ESKD) refers to irreversible damage to the kidneys to the point where they are no longer able to perform their basic functions of clearing toxins from the blood, managing electrolytes such as potassium, and removing excess fluid from the body.
What Causes End-Stage Kidney Disease?
There are many causes of ESKD, with the most common being diabetic kidney disease followed by hypertension. Other disorders include vascular disease, genetic conditions such as polycystic kidney disease and disorders affecting the filter of the kidney, which is called glomerulonephritis and can be caused by many different processes.
Symptoms of End-Stage Kidney Disease
Most people with chronic kidney disease (CKD) do not experience any specific symptoms. However, as kidney function declines, they may start to develop symptoms of kidney failure, called uremia, which commonly includes poor appetite, nausea, weight loss, confusion, insomnia, and fatigue. They may also experience swelling and worsening blood pressure control due to the kidney’s inability to remove excess fluid.
Diagnosing End-Stage Kidney Disease
Blood tests can detect the degree of kidney impairment, problems with electrolytes, such as potassium, and issues with managing acid that accumulates in the body. All of these findings indicate the need for an alternative means to filtering the blood.
Treating End-Stage Kidney Disease
Ideally, kidney transplantation should be pursued. However, if the patient is not a candidate for, or unable to get a kidney transplant before the need arises, then dialysis is an option.
There are a variety of dialysis options, including incenter hemodialysis, peritoneal dialysis, home hemodialysis, and nocturnal hemodialysis. Kidney transplantation requires referral to an approved transplant center where one may be eligible for a living donor or a deceased donor transplant.
