Robert Wood Johnson University Hospital
 

End Stage Renal Disease (ESRD)

End Stage Renal Disease (ESRD)

Illustration of the anatomy of the kidney
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What is renal failure?

Renal failure refers to temporary or permanent damage to the kidneys that results in loss of normal kidney function. There are two different types of renal failure--acute and chronic. Acute renal failure has an abrupt onset and is potentially reversible. Chronic failure progresses slowly over at least three months and can lead to permanent renal failure. The causes, symptoms, treatments, and outcomes of acute and chronic are different.

Conditions that may lead to acute or chronic renal failure may include, but are not limited to, the following:

Acute Renal FailureChronic Renal Failure
Myocardial infarction. A heart attack may occasionally lead to temporary kidney failure. Diabetic nephropathy. Diabetes can cause permanent changes, leading to kidney damage.
Rhabdomyolysis. Kidney damage that can occur from muscle breakdown. This condition can occur from severe dehydration, infection, or other causes. Hypertension. Chronic high blood pressure (hypertension) can lead to permanent kidney damage.
Decreased blood flow to the kidneys for a period of time. This may occur from blood loss or shock. Lupus (SLE). Chronic inflammatory/autoimmune disease that can injure the skin, joints, kidneys, and nervous system.
An obstruction or blockage along the urinary tract. A prolonged urinary tract obstruction or blockage.
Hemolytic uremic syndrome. Usually caused by an E. coli infection, kidney failure develops as a result of obstruction to the small functional structures and vessels inside the kidney. Alport syndrome. An inherited disorder that causes deafness, progressive kidney damage, and eye defects.
Ingestion of certain medications that may cause toxicity to the kidneys. Nephrotic syndrome. A condition that has several different causes. Nephrotic syndrome is characterized by protein in the urine, low protein in the blood, high cholesterol levels, and tissue swelling.
Glomerulonephritis. A type of kidney disease that involves glomeruli. During glomerulonephritis, the glomeruli become inflamed and impair the kidney's ability to filter urine. Glomerulonephritis may lead to chronic renal failure in some individuals. Polycystic kidney disease. A genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys.
Any condition that may impair the flow of oxygen and blood to the kidneys such as cardiac arrest. Cystinosis. An inherited disorder in which the amino acid cystine (a common protein-building compound) accumulates within specific cellular bodies of the kidney, known as lysosomes.
  Interstitial nephritis or pyelonephritis. An inflammation to the small internal structures in the kidney.

What is end-stage renal disease (ESRD)?

End-stage renal disease is when the kidneys permanently fail to work.

What are the symptoms of renal failure?

The symptoms for acute and chronic renal failure may be different. The following are the most common symptoms of acute and chronic renal failure. However, each individual may experience symptoms differently. Symptoms may include:

Acute: (Symptoms of acute renal failure depend largely on the underlying cause.)

Chronic:

The symptoms of acute and chronic renal failure may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is renal failure diagnosed?

In addition to a physical examination and complete medical history, diagnostic procedures for renal failure may include the following:

What is the treatment for acute and chronic renal failure?

Specific treatment for renal failure will be determined by your doctor based on:

Treatment may include:

In some cases, patients may develop severe electrolyte disturbances and toxic levels of certain waste products normally eliminated by the kidneys. Patients may also develop fluid overload. Dialysis may be indicated in these cases.

Treatment of chronic renal failure depends on the degree of kidney function that remains. Treatment may include:

What is dialysis?

Dialysis is a procedure that is performed routinely on persons who suffer from acute or chronic renal failure, or who have ESRD. The process involves removing waste substances and fluid from the blood that are normally eliminated by the kidneys. Dialysis may also be used for individuals who have been exposed to or ingested toxic substances to prevent renal failure from occurring. There are two types of dialysis that may be performed, including the following:

Long-term outlook for ESRD

People with ESRD are living longer than ever. Dialysis treatments (both hemodialysis and peritoneal dialysis) are not cures for ESRD, but will help you feel better and live longer. Over the years, ESRD can cause other problems such as bone disease, high blood pressure, nerve damage, and anemia (having too few red blood cells). You should discuss prevention methods and treatment options for these potential problems with your doctor.

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Online Resources of Kidney and Urinary Disorders

 

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