End-stage renal disease

Alternative names:

ESRD; kidney failure - end stage; renal failure - end stage

Treatment:

Dialysis or kidney transplantation are the only treatments for ESRD. The physical condition of the person and other factors determines which of these is used for treatment. Other treatments of chronic renal failure may continue but are ineffective without dialysis or transplantation.Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, congestive heart failure, urinary tract infections, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated as appropriate.Blood transfusions and medications such as iron and erythropoietin may be needed to control anemia.Fluids may be restricted to an amount nearly equal to the volume of urine produced. Dietary restrictions may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Restrictions include low protein in diet, with high carbohydrate levels to make up calories. Salt, potassium, phosphorus, and other electrolytes may be restricted.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See kidney disease - support group.

Expectations (prognosis):

ESRD is fatal unless treated with dialysis or transplantation. Both of these treatments can have serious risks and consequences. The outcome varies and is unique to each individual.

Complications:

• complications of dialysis and kidney transplantation
• pericarditis, cardiac tamponade
• congestive heart failure
• hypertension
• platelet dysfunction
• gastrointestinal loss of blood, duodenal or peptic ulcers
• hemorrhage
• anemia
• hepatitis B, hepatitis C, liver failure
• decreased functioning of white blood cells and immune system
• infection
• peripheral neuropathy
• seizures
• encephalopathy, nervous system damage, dementia
• weakening of the bones, fractures, joint disorders
• permanent skin pigmentation changes
• skin dryness, itching/scratching with resultant skin infection
• changes in glucose metabolism
• changes in electrolyte levels
• decreased libido, impotence
• miscarriage, menstrual irregularities, infertility

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms indicating end-stage renal disease have developed.Call your health care provider if known acute or chronic renal failure persists or worsens.