End Stage Kidney Disease

What is End Stage Kidney Disease

End stage kidney disease occurs when the kidneys are so damaged that they cannot function and cannot get better.

This condition may also be referred to as end stage renal disease or ESRD. The kidneys are two organs that do many important jobs in the body, including:

• Removing wastes and extra fluids from the blood.
• Making hormones that maintain the amount of fluid in your tissues and blood vessels.
• Maintaining the right amount of fluids and chemicals in the body.

Without functioning kidneys, toxins build up in the blood and life-threatening complications can occur.

What are the causes?

This condition usually occurs when a long-term (chronic) kidney disease gets worse and results in permanent damage to the kidneys. It may also be caused by sudden damage to the kidneys (acute kidney injury).

Causes of this condition include:

• Having a family history of chronic kidney disease (CKD).
• Having chronic kidney disease for many years.
• Chronic medical conditions that affect the kidneys, such as:
  • Cardiovascular disease, including high blood pressure.
  • Diabetes.
  • Certain diseases that affect the body’s disease-fighting (immune) system.
• Overuse of over-the-counter pain medicines.
• Being around or being in contact with poisonous (toxic) substances.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Being older than 60.
• Being male.
• Being of African-American, Asian, Native American, Pacific Islander, or Hispanic descent.
• Smoking or a history of smoking.
• Obesity.

What are the signs or symptoms?

Symptoms of this condition include:

• Swelling (edema) of the face, legs, ankles, or feet.
• Numbness, tingling, or loss of feeling in the hands or feet.
• Tiredness (lethargy).
• Nausea or vomiting.
• Confusion, trouble concentrating, or loss of consciousness.
• Chest pain.
• Shortness of breath.
• Passing little or no urine.
• Muscle twitches and cramps, especially in the legs.
• Dry, itchy skin.
• Loss of appetite.
• Pale skin due to anemia, including the skin and tissue around the eye (conjunctiva).
• Headaches.
• Abnormally dark or light skin.
• Decrease in muscle size (muscle wasting).
• Easy bruising.
• Frequent hiccups.
• Stopping of the monthly period in women.
• Jerky movements (seizures).

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam, including blood pressure measurements.
• Urine tests.
• Blood tests.
• Imaging tests.
• A test in which a sample of tissue is removed from the kidneys to be examined under a microscope (kidney biopsy).

How is this treated?

This condition may be treated with:

• A procedure that removes toxic wastes from the body (dialysis). There are two types of dialysis:
  • Dialysis that is done through your abdomen (peritoneal dialysis). This may be done several times a day.
  • Dialysis that is done by a machine (hemodialysis). This may be done several times a week.
• Surgery to receive a new kidney (kidney transplant).

In addition to having dialysis or a kidney transplant, you may need to take medicines:

• To control high blood pressure (hypertension).
• To control high cholesterol.
• To treat diabetes.
• To maintain healthy levels of minerals in the blood (electrolytes).

You may also be given a specific meal plan to follow that includes requirements or limits for:

• Salt (sodium).
• Protein.
• Phosphorous.
• Potassium.
• Calcium.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do nottake any new medicines, vitamins, or mineral supplements unless approved by your health care provider. Many medicines and supplements can worsen kidney damage.
• Follow instructions from your health care provider about adjusting the doses of any medicines you take.

Lifestyle

• Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Achieve and maintain a healthy weight. If you need help with this, ask your health care provider.
• Start or continue an exercise plan. Exercise at least 30 minutes a day, 5 days a week.
• Follow your prescribed meal plan.

General instructions

• Stay current with your shots (immunizations) as told by your health care provider.
• Keep track of your blood pressure. Report changes in your blood pressure as told by your health care provider.
• If you are being treated for diabetes, monitor and track your blood sugar (blood glucose)levels as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• American Association of Kidney Patients: www.aakp.org
• National Kidney Foundation: www.kidney.org
• American Kidney Fund: www.akfinc.org
• Life Options Rehabilitation Program: www.lifeoptions.organd www.kidneyschool.org

Contact a health care provider if:

• Your symptoms get worse.
• You develop new symptoms.

Get help right away if:

• You have weakness in an arm or leg on one side of your body.
• You have difficulty speaking or you are slurring your speech.
• You have a sudden change in your vision.
• You have a sudden, severe headache.
• You have a sudden weight increase.
• You have difficulty breathing.
• Your symptoms suddenly get worse.

Summary

• End stage kidney disease occurs when the kidneys are so damaged that they cannot function and cannot get better.
• Without functioning kidneys, toxins build up in the blood and life-threatening complications can occur.
• Treatment may include dialysis or a kidney transplant along with medicines and lifestyle changes.