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Endstage Renal Disease

The word "renal" comes from "renes," the Latin word for "kidneys." End stage renal disease (ESRD) is when the kidneys permanently fail to function. The National Kidney Foundation estimates that there are about 90,000 new cases of ESRD every year. Since the only treatments for end stage renal disease are dialysis or an organ transplant, prevention and early diagnosis are critical.

  1. Definition

    • Renal failure results when the kidneys have been damaged and can no longer perform their role of removing wastes from the blood and maintaining a balance of water. Renal failure can be acute or chronic. Acute kidney failure may be reversible, while the chronic type has a higher chance of progressing to ESRD.

    Acute Renal Failure

    • Acute renal failure happens suddenly, which means that the damage to the kidneys has existed for a shorter time. The most common causes are heart attack, muscle damage, blood loss due to trauma, a blockage in the urinary tract, medications, glomerulonephritis and E. coli infection. Most of these have one thing in common: they impair the flow of blood to the kidneys. Glomerulonephritis is an inflammation of the glomeruli, which are the structures that filter urine. The inflammation prevents them from working and can lead to chronic renal failure.

    Chronic Renal Failure

    • Chronic renal failure occurs when the kidneys do not function properly over a period of time. Because it often continues undetected, it frequently leads to ESRD. Diabetes and high blood pressure are the two leading causes of chronic renal failure. According to the American Diabetes Association, diabetes is the leading cause of end stage renal disease, accounting for about 43 percent of all new cases. Other causes of chronic renal failure include inherited disorders, a prolonged urinary tract obstruction, inflammation and lupus.

    Symptoms

    • Some of the symptoms for acute and chronic renal failure are the same, such as fatigue, vomiting, poor appetite, muscle cramps, pale skin, recent or recurrent urinary tract infections, and either low or high amounts of urine. An acute failure is sometimes accompanied by fever, diarrhea and hemorrhage. Unique chronic symptoms include insomnia, dry skin, urinary incontinence, bad breath, irritability and a change in mental status.

    Treatment

    • Treatment for acute and chronic renal failure consists of intravenous fluids, medications and a special diet. Once ESRD has occurred there are only two options: dialysis and kidney transplantation. Peritoneal dialysis uses a surgically implanted tube to insert special fluid into the abdomen that absorbs wastes and is then drained. One type is done without a machine, but machines are often used to perform peritoneal dialysis at home or in the hospital for longer treatments. Hemodialysis can also be done at home or in the hospital, but uses an intravenous catheter connected to a machine that drains blood, removes wastes, and then returns it to the body.

      Kidney transplantation---replacing the failed kidney with a healthy kidney from a donor---is not a complete cure but it does allow people to live longer. The major problem with this treatment is that there is a shortage of donor kidneys available and very few people who need a transplant receive a kidney.

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