End-Stage Renal Failure
The final stage of chronic kidney disease, end-stage renal failure occurs when the kidneys can no longer filter the blood.
A pair of bean-shaped organs located below the ribs on either side of the spine, the kidneys filter the blood, regulate the amount of fluid in the body and remove liquid waste in the form of urine. Chronic kidney disease causes a gradual loss of kidney function that can eventually lead to end-stage renal failure, which occurs when the kidneys are no longer able to keep up with the body’s demands for waste and fluid clearance.
Causes of End-Stage Renal Failure
End-stage renal failure results from chronic kidney disease, which can be caused by:
- Diabetes
- High blood pressure
- Heart disease
- Kidney stones
- Recurrent urinary tract infections
- An autoimmune condition, such as lupus
- Polycystic kidney disease (an inherited condition that causes cysts to form in the kidneys)
Symptoms of End-Stage Renal Failure
The signs of early-stage kidney disease are often unnoticeable or nonspecific. As chronic kidney disease progresses to end-stage renal failure, a variety of symptoms can occur, such as:
- Loss of appetite
- A metallic taste in the mouth
- Nausea or vomiting
- Weakness and fatigue
- Decreased alertness or mental confusion
- Difficulty sleeping or oversleeping
- Changes in urine production
- Muscle twitching or cramping
- Itchiness
- Swollen ankles and feet
- Shortness of breath
- Chest pain
Because the kidneys can often adapt to and compensate for their decreased function, the symptoms of chronic kidney disease may not become apparent until irreversible damage or end-stage renal failure has occurred.
Diagnosis of End-Stage Renal Failure
Chronic kidney disease progresses through five stages. To determine the stage, a physician will typically order a blood test to evaluate the glomerular filtration rate (GFR), which measures the amount of blood filtered by the kidneys each minute. GFR is expressed in terms of milliliters per minute (mL/min). A decline in the GFR indicates a corresponding decline in kidney function. Usually, end-stage renal failure occurs when kidney function falls below 10% of normal, which is generally indicated by a GFR of 15 or lower.
Treatments for End-Stage Renal Failure
Although there is no cure for chronic kidney disease, the condition can be treated with medication to address the underlying cause and slow the progression of the resulting kidney damage.
However, end-stage renal failure will require either:
- Dialysis – The use of a machine to artificially filter waste products and extra fluid from the blood
- A kidney transplant – The surgical removal of the damaged kidney, which is replaced with a healthy kidney from a donor
The renowned nephrology team at Tampa General Hospital offers the latest diagnostic and treatment options for chronic kidney disease and end-stage renal failure. We work closely with each patient, developing a tailored treatment plan to help him or her achieve the best possible outcome and quality of life.