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END STAGE RENAL DISEASE

End-stage renal disease (ESRD) refers to kidney failure which is the most severe and last stage of chronic kidney disease (CKD). In these patients, the kidneys completely stop working and can no longer eliminate the waste materials from the body. ESRD can further progress and lead to the death of the person if there is a delay in the treatment.

Symptoms

The various signs and symptoms of end-stage renal disease are:

  • Fatigue
  • General feeling of illness
  • Decrease in the volume of urine
  • Inability to urinate
  • Loss of appetite
  • Dry skin and itching
  • Unexplained weight loss
  • Changes in the skin color
  • Difficulty to concentrate
  • Bone pain

Other symptoms may include:

  • Bad breath
  • Excessive thirst
  • Edema of legs and hands
  • Frequent nose bleeding
  • Numbness of hands and feet
  • Sleeping difficulty
  • Impotence

Causes

Usually, end-stage renal disease results from other medical conditions which cause a permanent damage to the kidneys. Some of the common causes of kidney failure are as follows:

  • Diabetes and high blood pressure are the two most important causes of ESRD. If they are not properly managed, these two diseases can damage the filtering units of the kidneys, i.e. the glomeruli.
  • Autoimmune diseases such as IGA nephropathy and lupus may cause ESRD.
  • Urinary tract problems such as a blockage by an enlarged prostate in men or kidney stones or certain cancers may also cause end-stage renal disease.
  • Inflammation of the filters of the kidneys called glomeruli, a condition called glomerulonephritis may be one of the causes of ESRD.
  • Genetic diseases such as polycystic kidney disease (PKD) may also cause end-stage renal disease.

Risk factors

The below factors may increase the risk of developing end-stage renal disease:

  • Medical conditions such as diabetes and hypertension
  • A history of kidney problems
  • Advancing age
  • Smoking and tobacco use

When to consult the doctor?

Visit the doctor immediately if any of the symptoms of kidney failure become bothersome in day to day life. It is especially important to seek immediate medical attention if any of the below problems are present:

  • Problem with urination
  • Sleeping difficulty
  • Frequent vomiting
  • Weakness
  • Inability to do daily activities

Diagnosis

The doctor performs a physical examination of the patient which includes checking for blood pressure, height, weight, etc. Further, a personal history and family history is collected. The doctor may recommend the below-mentioned tests to understand the extent of kidney damage:

  • Blood tests are performed to detect the levels of waste materials such as creatinine and urea
  • Urine sample tests detect the amount of protein albumin which is an indication of kidney disease
  • Imaging tests such as a CT scan and an MRI may be performed to identify the defects in the size and structure of the kidneys
  • A biopsy of the kidneys is recommended, which gives the details of the extent of damage

Treatment

 

The primary treatments of kidney failure are dialysis and kidney transplant.

  • Kidney transplant involves a surgical replacement of the damaged kidney with a healthy kidney taken from a healthy donor. This is the best treatment option for ESRD as compared to the lifelong dialysis. Recovery from the surgery takes some days. Medications will be given to prevent the surgery related complications such as infections and bleeding.
  • Dialysis is an artificial method of filtering the waste materials using a machine. It can be undergone either at home or at doctor’s office based on the type of dialysis.
  • Additionally, the doctor may recommend a strict diet plan such as taking very low proteins, salt, etc.

Lifestyle and home remedies

The below measures can help in delaying the progress of kidney disease:

  • Taking medicines as prescribed
  • Maintaining healthy weight
  • Following a healthy diet which is low in sodium, proteins and potassium
  • Quitting smoking and tobacco use
  • Being physically active
  • Controlling the blood pressure and blood sugar levels by taking medicines regularly
  • Going for regular health check-ups
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