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Who Gets End Stage Renal Disease?

End stage renal disease (ESRD) is the almost complete loss of kidney function. This means your kidneys are unable to perform well enough to keep you alive. The only treatments available for this disease are a kidney transplant or dialysis. ESRD occurs in the late stages of chronic kidney disease (CKD). Diseases such as diabetes and high blood pressure may also lead to ESRD. 

If you are worried you will develop ESRD, certain diseases that can lead to it should be diagnosed as soon as possible. Some kidney diseases are difficult to diagnose without proper testing. Polycystic kidney disease (PKD) is a hereditary disorder. By making your doctor aware of your family’s medical history with this illness, it can be tested for and monitored. Glomerulonephritis swells and scars the filters in the kidneys, called nephrons. A biopsy or an MRI may be necessary to accurately diagnose this condition. Early treatment of these diseases may prevent the rapid progression to ESRD. Chronic kidney disease, however, is often not diagnosed until significant damage has been done, and patients are on the verge of ESRD.

CKD is a progressive disease

In the early stages of CKD, most patients are unaware their kidneys are damaged. Since the kidneys have millions of nephrons (tiny structures inside the kidneys that filter your blood), a few damaged nephrons will have very little effect on the kidneys’ ability to function. However, CKD is ongoing. More and more nephrons can become damaged until the remaining healthy nephrons may be unable to efficiently filter the wastes and excess fluid from your bloodstream. This damage occurs over time. Chronic kidney disease may exist for 10 to 20 years before progressing to end stage renal disease.  Unfortunately, even with an early diagnosis of CKD, the condition is often irreversible. But it may be managed so that the progression to ESRD is slowed significantly.  Without proper treatment, ESRD can develop much sooner than expected, and you will need to undergo dialysis or a kidney transplant.

Other diseases that can lead to ESRD

Diabetes and high blood pressure are two diseases that cause more than 60 percent of all end stage renal diseases in the United States.

A routine physical exam often can diagnose these two conditions. Patients with diabetes or high blood pressure are already at risk for CKD. Diabetics have excess sugar in their bloodstream. This excess sugar can affect the glomerulus, a small filtering structure in the nephron. High blood pressure can damage the nephrons themselves. If you are already being treated for CKD, and you have diabetes or high blood pressure, extra care must be taken to follow your healthcare team’s advice. 

Lupus, kidney stones and repeated kidney infections may all lead to ESRD. The constant use of painkillers and other medications can also cause significant kidney damage. Make your doctor aware of all medication (prescribed and over the counter) that you may be taking.

Treatments for ESRD

The only treatment available to those who do develop ESRD is dialysis or a kidney transplant. These are the treatments that can keep you alive. Without them, you will continue to accumulate toxins and excess fluid in your bloodstream causing your major organs to shut down, which can lead to death.

When diagnosed with ESRD, extra steps must be taken to ensure that your dialysis treatment or kidney transplant will work effectively. Your doctor and dietitian will be closely monitoring your lab results and provide direction on diet and fluid intake. You may also be on medication to manage high blood pressure or diabetes. If you were previously diagnosed with CKD, you may also continue those treatments. 

With the early detection of the underlying causes of ESRD, your healthcare team may help you slow the progression of ESRD. You can take an active role. By being aware of your family’s medical history, going in for regular check ups, taking medication prescribed for your high blood pressure or diabetes and following your doctor’s advice, you may prolong the life of your kidneys and delay the need for dialysis or a kidney transplant.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a Kidney Doctor tool to locate a nephrologist in your area.