End-stage kidney disease Health Article

Definition

End-stage kidney disease is the complete, or almost complete failure of the kidneys to function. The kidneys can no longer remove wastes, concentrate urine, and regulate electrolytes.

Alternative Names

Renal failure - end stage; Kidney failure - end stage; ESRD

Causes, incidence, and risk factors

End-stage kidney disease occurs when the kidneys are no longer able to function at a level that is necessary for day-to-day life. It usually occurs when chronic kidney failure has progressed to the point where kidney function is less than 10% of normal.

The most common cause of ESRD in the U.S. is diabetes. ESRD almost always follows chronic kidney failure. A person may have kidney failure for 10 - 20 years or more before progressing to ESRD.

Symptoms

• Decreased alertness
  • Drowsiness, somnolence, lethargy
  • Confusion, delirium
  • Coma
• Decreased sensation in the hands, feet, or other areas
• Decreased urine output
• Easy bruising or bleeding
• Fatigue
• Frequent hiccups
• General ill feeling
• Headache
• Increased skin color (pigmentation)
• Itching
• May have blood in the vomit or stools
• Muscle twitching or cramps
• Nail abnormalities
• Nausea or vomiting
• No urine output
• Seizures
• Skin may appear yellow or brown
• Unintentional weight loss

Signs and tests

There may be a long history of chronic kidney failure, which has progressed. The urine volume may decrease or urine production may stop totally. Signs of complications commonly are present.

Tests may include:

• Creatinine and BUN levels
• Creatinine clearance