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Conditions InDepth: End-stage Renal Disease (ESRD)

Renal (kidney) failure, is the inability of the kidneys to perform their normal functions. The kidneys are 2 bean-shaped organs on either side of the spine in the lower back. Their main functions are to remove waste from the body and to balance the water and mineral content of the blood by filtering waste, minerals, and water. The waste and water combine to form urine.
Anatomy of the Kidney
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End-stage renal disease (ESRD) is a permanent condition in which the kidneys are no longer able to filter waste from the blood. As the wastes build up, the tiny filters (nephrons) in the kidneys continue to lose their filtering ability. Although damage to the nephrons may occur suddenly after an injury or poisoning, many kidney diseases take years or decades to cause noticeable damage. ESRD is generally diagnosed when kidney function drops to 10% of normal. The 2 most common causes of ESRD are:
  • Diabetes—the nephrons are damaged by chronically high blood sugar levels that occur in poorly controlled diabetes
  • High blood pressure—causes damage to the blood vessels in the kidneys
End-stage renal disease can lead to anemia, high blood pressure, bone disorders, heart failure, and mental confusion.
What are the risk factors for end-stage renal disease?What are the symptoms of end-stage renal disease?How is end-stage renal disease diagnosed?What are the treatments for end-stage renal disease?Are there screening tests for end-stage renal disease?How can I reduce my risk of end-stage renal disease?What questions should I ask my doctor?What is it like to live with end-stage renal disease?Where can I get more information about end-stage renal disease?


Chronic kidney disease (CKD) in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.
What I need to know about kidney failure and how it's treated. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/kidney-failure-choosing-a-treatment-thats-right-for-you/Pages/ez.aspx. Updated September 15, 2010. Accessed July 2, 2013.
What is kidney failure? National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/kidneyFailure. Accessed July 2, 2013.
Yu HT. Progression of chronic renal failure. Arch Int Med. 2003;163(12):1417-1429.

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