End-stage kidney disease

Alternative Names

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. Other treatments of chronic kidney failure may continue but are unlikely to work without dialysis or transplantation. Current therapy includes aggressive treatment of high blood pressure with an ACE inhibitor or an angiotensin receptor blocker.

Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension (high blood pressure), congestive heart failure, urinary tract infections, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated.

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 a low- protein diet, with high carbohydrate levels to make up for the lost calories. Salt, potassium, phosphorus, and other electrolytes may be restricted.

Support Groups

For additional resources, see kidney disease support group.

Outlook (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.

Possible Complications

• 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

When to Contact a Medical Professional

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