The kidneys are vital organs that serve the body by removing waste and toxins, helping to keep blood pressure stable, and creating new red blood cells. End-stage renal disease (ESRD) means that the kidneys are not working and will never recover, and can be more precisely defined as kidneys that are working at no more than 10% of their capacity. This condition does not usually occur quickly, and many people live for years with kidney failure but still function. However, they can ultimately progress to ESRD. Without treatment, this condition is fatal, but fortunately there is a treatment that can help prolong the lives of many.
As mentioned, it is not that common for ESRD to occur suddenly. This doesn't mean you can't. Fatal reactions to drugs or poisons, or some injuries can lead to total kidney dysfunction. Other causes of sudden ESRD include birth defects. However, most people can spend time in kidney failure for years at first, often as a result of conditions such as high blood pressure, diabetes, or lupus. Sometimes chronic kidney disease improves and other times it progresses to the end stage. Doctors will watch this carefully.
Patients with chronic renal failure may be told to look for additional symptoms of end-stage renal disease. These can include no or decreased urination, blood in the stool, vomiting, and extreme fatigue. It is possible to go from feeling fatigued to absolutely exhausted or confused and slip into a coma. Others may experience flu-like symptoms, have muscle cramps, or bruise extremely easily. Without treatment, the body would shut down completely and the result would be death.
Certainly, there are treatment options for most people with ESRD. They can choose to have dialysis of two types, called hemodialysis or peritoneal dialysis. Alternatively, kidney transplant may be an option.
Hemodialysis can be done in a medical facility or sometimes at home. It removes blood from the body, usually from a tube attached to the arm, and filters it of waste before putting it back into the body through another tube. Hemodialysis for end-stage kidney disease needs to be done several times a week.
Peritoneal dialysis uses a catheter permanently placed in the abdomen, which is connected to a bag or filter machine at intervals. The body receives a fluid called dialysate, which helps clean the blood, and this is removed through a bag or machine. The different types of peritoneal dialysis can be discussed with a doctor.
Lastly, kidney transplantation may be an option for many people, but they have to have a matched donor. Family members in very good health can donate a kidney, since it is possible to live with only one. However, if the cause of ESRD is an inherited condition, younger family members risk their own eventual health by donating, which deserves consideration. Kidney transplant methods continue to improve and can add years to life.
Some people choose not to treat ESRD. If there are many quality of life issues, or if a person is elderly, they may not want to treat the condition and may have a living will stating this fact. However, for many others, it should be heartening to know that the failure of these vital organs can now be addressed in many ways.