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End-stage renal disease

Medically reviewed by Drugs.com. Last updated on Jun 9, 2025.

What is end-stage renal disease?

Harvard Health Publishing

End-stage renal disease is a condition in which the kidneys no longer function normally. Renal describes anything having to do with the kidneys. Nearly everyone is born with two kidneys. They both need to fail for end-stage renal disease to develop.

Kidneys eliminate poisons from the body and keep a normal balance of fluid and certain minerals in the body. When the kidneys can no longer perform this function, a person becomes seriously ill and ultimately dies.

In end-stage renal disease, the kidneys function at a fraction of their normal capacity. When this occurs, there are only two options:

Diabetes is the leading cause of end-stage renal disease. Kidney disease can result from type 1 or type 2 diabetes. With either type, poor control of blood sugar increases the risk of end-stage renal disease.

Other common causes of end-stage renal disease are:

End-stage renal disease

Symptoms of end-stage renal disease

Symptoms of end-stage renal disease include:

Symptoms may remain mild or absent until kidney function drops to less than 20% of normal.

Dialysis is urgent when one or more of the following occurs:

Dialysis may also be necessary if symptoms affect quality of life or nutritional status. This is especially true if they are accompanied by severely abnormal blood tests.

Diagnosing end-stage renal disease

Kidney disease is diagnosed through urine and blood tests. These tests measure levels of creatinine and urea nitrogen in the urine and blood.

Additional tests may be necessary to determine why the kidneys have stopped working. For example, a kidney biopsy may be recommended, in which a tiny sample of kidney tissue is removed and carefully examined under a microscope.

Expected duration of end-stage renal disease

End-stage renal disease is almost always a lifelong condition unless a kidney transplant is done. Even with a successful transplant, a person must take medicine for the rest of his or her life.

Preventing end-stage renal disease

You can take steps to reduce your risk of developing end-stage renal disease:

Treating end-stage renal disease

The two treatments for end-stage renal disease are dialysis and kidney transplant.

Dialysis

There are two types of dialysis:

Kidney transplants

Kidney transplants allow people with severe kidney disease to avoid or discontinue dialysis.

Anyone who receives a kidney transplant must take immunosuppressive drugs for life, unless they received a kidney donated by their identical twin. These are drugs that prevent the body from rejecting the donated organ. In addition, a good genetic match is needed for a successful transplant. Most transplant candidates wait one to three to five years before a good genetic match can be found from an unrelated donor.

When to call a professional

You should have regular checkups if you have:

These checkups should include urine and blood tests to measure your kidney function.

When blood tests indicate kidney disease, your doctor should refer you to a kidney specialist. This specialist is called a nephrologist.

Call your doctor if you notice any decrease in urination or other symptoms of end-stage renal disease. Be particularly vigilant if you have kidney disease or its risk factors.

Prognosis

Treatments for end-stage renal disease offer hope for good recovery and quality of life. Although people requiring dialysis or who have had a kidney transplant have a somewhat shorter average lifespan than the general population, they can lead near normal lives for many years.

Additional info

National Institute of Diabetes & Digestive & Kidney Disorders
https://www.niddk.nih.gov/

National Kidney Foundation
https://www.kidney.org/


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.