End-Stage Renal Disease (ESRD)
What is End-Stage Renal Disease (ESRD)?
End-stage renal disease is the final stage of chronic kidney disease. Your kidneys have lost more than 90% of their ability to filter waste and excess fluid from your blood. At this stage, waste products and toxins build up in your body to dangerous levels.
ESRD is also called Stage 5 kidney disease. Without treatment, the condition is life threatening. Most people with ESRD need dialysis or a kidney transplant to survive. Dialysis is a medical procedure that filters your blood when your kidneys can no longer do the job.
The kidneys normally filter about 120 to 150 liters of blood each day. When kidney function drops below 15% of normal, your body cannot remove enough waste on its own. Early detection of declining kidney function can help you and your doctor plan the best treatment path.
Symptoms
- Severe fatigue and weakness that interferes with daily activities
- Swelling in your legs, ankles, feet, or face from fluid buildup
- Shortness of breath from fluid in the lungs
- Nausea, vomiting, and loss of appetite
- Confusion or difficulty concentrating
- Itching all over your body
- Muscle cramps and twitching
- Little to no urine output
- Metallic taste in your mouth or ammonia breath
- Sleep problems or restless legs at night
Many people have few symptoms until kidney function is severely reduced. This is why regular blood testing is essential if you have risk factors for kidney disease.
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Causes and risk factors
ESRD develops when chronic kidney disease progresses over months or years. Diabetes is the leading cause, accounting for about 40% of cases. High blood pressure causes another 25% of cases. Uncontrolled blood sugar damages the tiny blood vessels in your kidneys. High blood pressure puts excessive strain on kidney tissue over time.
Other causes include autoimmune diseases like lupus, chronic kidney infections, polycystic kidney disease, and prolonged use of certain medications. Repeated episodes of acute kidney injury can also lead to permanent damage. Family history of kidney disease, age over 60, obesity, smoking, and heart disease all increase your risk. African Americans, Hispanics, Native Americans, and Asian Americans face higher rates of kidney disease.
How it's diagnosed
ESRD is diagnosed through blood tests that measure kidney function. The estimated glomerular filtration rate, or eGFR, shows how well your kidneys filter blood. An eGFR below 15 mL/min/1.73m² indicates Stage 5 kidney disease or ESRD. Blood urea nitrogen, or BUN, measures waste products in your blood. BUN levels above 100 mg/dL often signal ESRD and the need for dialysis.
Rite Aid tests include eGFR and BUN to help detect declining kidney function before ESRD develops. Your doctor may also order urine tests, imaging scans, or a kidney biopsy. Early monitoring lets you take action to slow disease progression and plan for treatment options.
Treatment options
- Dialysis to remove waste products and excess fluid from your blood
- Kidney transplant surgery if you are a candidate
- Medications to control blood pressure, anemia, bone disease, and other complications
- Low sodium diet to reduce fluid retention and blood pressure
- Protein restriction to reduce waste buildup, guided by your care team
- Phosphorus and potassium limits to protect your heart and bones
- Regular physical activity as tolerated to maintain strength
- Smoking cessation to improve overall health outcomes
- Blood sugar management if you have diabetes
- Coordination with a nephrologist, or kidney specialist
Concerned about End-Stage Renal Disease (ESRD)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Chronic kidney disease has five stages based on how well your kidneys work. ESRD is Stage 5, the most severe stage. At this point, your kidneys have lost more than 90% of function. You need dialysis or a transplant to survive with ESRD.
ESRD cannot be reversed because the kidney damage is permanent. A kidney transplant can restore kidney function, but it does not cure the underlying disease. Dialysis supports your body but does not repair your kidneys. Early treatment of kidney disease can prevent progression to ESRD.
Most people need dialysis three times per week for about four hours each session. This schedule removes enough waste and fluid to keep you stable between treatments. Some people do home dialysis more frequently with shorter sessions. Your care team creates a schedule based on your needs.
An eGFR below 15 mL/min/1.73m² means your kidneys are working at less than 15% of normal capacity. This defines Stage 5 kidney disease or ESRD. At this level, waste products build up quickly in your blood. Most people need to start dialysis or consider a transplant.
BUN rises above 100 mg/dL when your kidneys can no longer filter urea from your blood. Urea is a waste product from protein breakdown. High BUN causes uremic symptoms like nausea, confusion, and itching. These levels usually indicate the need to start dialysis soon.
Diet is an essential part of ESRD management. You need to limit sodium, potassium, phosphorus, and sometimes protein. These changes reduce stress on your remaining kidney function and prevent dangerous complications. A renal dietitian can create a meal plan that works for you.
Life expectancy varies widely based on age, other health conditions, and how well dialysis works. Many people live 5 to 10 years or longer on dialysis. Younger people and those without other serious diseases often live longer. Quality of life depends on following your treatment plan closely.
Early kidney disease often has no symptoms. As function declines, you may notice swelling, fatigue, changes in urination, or trouble sleeping. By the time ESRD develops, symptoms become severe. Regular blood tests catch kidney problems before you feel sick.
A successful kidney transplant usually offers better quality of life and longer survival than dialysis. You have fewer dietary restrictions and more energy. However, not everyone qualifies for a transplant. You need to take medications for life to prevent organ rejection.
Yes, many people can slow or stop kidney disease progression with early action. Control your blood sugar and blood pressure carefully. Eat a kidney friendly diet and avoid medications that harm the kidneys. Regular monitoring with blood tests helps you catch problems early and adjust your treatment plan.