Chronic Renal Failure: What You Should Know About End-Stage Renal Disease

Chronic kidney disease (CKD) is an all-too-common condition. It impacts about 30 million American adults, with millions more at increased risk or even unaware they have this potentially fatal illness, according to the National Kidney Foundation (NKF).

CKD can cause a continuation of kidney impairment over time, ultimately leading to chronic renal failure or end-stage renal disease (ESRD). If you or your loved one suffers from CKD, it's critical to know more about ESRD in hopes of preventing you from ever reaching that late stage.

Understanding ESRD and Chronic Renal Failure

The kidneys' primary function is to filter waste products out of the blood while retaining necessary products, like proteins. Chronic kidney disease, also referred to as chronic renal disease, generally refers to a gradual loss of that function over time.

When someone's kidney function is impaired, the body's filtration system has become leaky, per the Journal of the American Medical Association. Proteins can then seep into the urine, instead of remaining in the blood, decreasing urine production. This may ultimately result in kidney failure. When the kidneys fail, waste products can then leak into the blood and body tissues, damaging other organs and parts of the body.

Health care providers diagnose CKD after kidney impairment has lasted more than three months. Providers then offer further detailed CKD classifications, based on a patient's eGFR, or estimated glomerular filtration rate, which screens for kidney damage, according to The Renal Association.

CKD stage G5, often clinically referred to as end-stage renal disease (ESRD), is the last stage of chronic kidney disease and generally results in chronic renal failure. At this point, patients require dialysis or a kidney transplant. CKD stage G4 is considered advanced kidney damage, and the patient will likely need a kidney transplant or dialysis in the near future.

Causes and Risk Factors for ESRD

The leading causes of ESRD include diabetes, high blood pressure, glomerulenephritis (inflammation), and polycystic kidney disease. But besides these direct causes, patients may be at increased risk for chronic renal failure because of other factors:

• Currently have diabetes or high blood pressure (or both)
• Have a family history of kidney failure
• Are older
• Belong to a population group with a higher rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians
• Have high LDL ("bad") cholesterol and low HDL ("good") cholesterol
• Smoke
• Do not exercise regularly

If one or more of these risk factors is a concern for you, consider speaking with your doctor about more closely monitoring your kidney health.

Receiving Your ESRD Diagnosis: Testing and Treatment

If your doctor suspects problems with your kidney function, you can expect to undergo any of the following tests:

• Glomerular Filtration Rate (GFR) calculation: This determines your level of kidney function, based on a number of factors and your blood creatinine level.
• Ultrasound or CT scan of your kidneys and urinary tract: This test detects any physical or structural issues, such as irregularly sized organs, kidney stones, or tumors.
• Kidney biopsy: A biopsy detects specific types of kidney disease, the extent of kidney damage, and possibilities for treatment plans.

Your primary care doctor may also recommend a kidney specialist to provide additional consultation on your condition and treatment plan.

Depending on a range of factors and the cause of kidney function impairment, your treatment plan can vary. For example, lifestyle and dietary interventions are common, such as quitting smoking, increasing regular physical exercise, and limiting the intake of high-sodium, high-phosphate, and processed foods.

The severity of your kidney impairment may dictate other, more intensive and invasive treatment options. Most commonly, this could include a kidney transplant. Or you may need to begin regular hemodialysis treatments, which use a machine to clean your blood and are performed either at a dialysis center or your own home.

Because kidney damage is generally permanent, if you're at risk or already suffer from kidney-related issues, address these concerns with your doctor right away. Protecting your kidneys means protecting part of your body's natural defense system against waste and toxic substances' ability to damage other organs.

Chronic kidney disease management, even in its later stages, is within your grasp today.