What Is End Stage Renal Disease?

Kidneys are significant organs that contribute to your overall well-being. But when kidneys function at only below 10 to 15 percent of their normal capacity, they cannot effectively do their job, such as remove waste or excess fluid from your blood. End stage renal disease (ESRD) is the last stage (stage five) of chronic kidney disease (CKD). When CKD, polycystic kidney disease (PKD) or other kidney diseases develop into ESRD, dialysis or a kidney transplant is necessary to live.

What happens to my body when I have ESRD?

Reduced urination

Fully functioning kidneys clean the blood of wastes and excess fluid. These items are eliminated through urine. Because kidneys with ESRD do a very poor job of removing these items, waste and fluid build up to unhealthy levels in the body and can make you feel sick. This is a condition called uremia. When fluid is not removed from the body, tissues will swell and lead to a condition called edema. Excess fluid in the bloodstream can also increase blood pressure.

Unbalanced electrolytes

Electrolytes are minerals and salts such as magnesium, sodium and potassium. They are found in foods you eat and are essential to good health. However, too much or too little of these electrolytes can make you sick. Kidneys affected with ESRD cannot regulate the levels of electrolytes and changes in your body’s functions occur. Sodium can cause tissues to retain water. Excess potassium can cause an abnormal heart rhythm, which may lead to cardiac arrest. Too little magnesium can affect your heartbeat and cause changes in your mental state; too much can leave you feeling weak.

Hormone changes

Healthy kidneys make certain hormones. One is a parathyroid hormone (PTH) that activates vitamin D into a substance called calcitriol, helping your body absorb calcium. If your body cannot absorb calcium, your bones become fragile and may break. Another hormone your kidneys create is erythropoietin. Erythropoietin tells your body to make red blood cells, which carry oxygen to the cells throughout your body. If your red blood cell count is low, you may develop anemia, leaving you feeling weak and fatigued.

Abnormal enzyme production

Renin is an enzyme kidneys produce, and helps regulate sodium and potassium levels in the blood, as well as regulate blood pressure. When blood pressure drops, renin is released and starts a chemical reaction in the body that will produce a substance called angiotensin. Angiotensin causes your blood vessels to narrow, raising blood pressure. Angiotensin also signals the adrenal glands (found at the top of your kidneys) to release a hormone called aldosterone. Aldosterone tells the kidneys to retain salt (sodium) and excrete potassium. By retaining salt, the body keeps more water in the system. This water raises the blood volume and blood pressure. Kidneys affected by ESRD sometimes make too much renin, which keeps blood pressure levels high. This kind of high blood pressure can be difficult to treat.

What can I do to live better with ESRD?

Regular dialysis treatment, following your renal diet and taking prescribed medications can go a long way in managing ESRD. If you have been diagnosed with end stage renal disease, it is important to follow your healthcare team’s advice regarding treatment.

To locate a doctor who specializes in kidney care (called a nephrologist ) in your area, use DaVita’s Find a Kidney Doctor tool.

How Is Kidney Function Measured?

Learn how your glomerular filtration rate (GFR) serves as an indicator of kidney function.

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