Understanding End-Stage Renal Disease (ESRD)

The Facts on ESRD

ESRD, or kidney failure, is the final stage of chronic kidney disease. It is defined as the condition in which your kidneys lose 90% or more of their total function. Your kidneys play an extremely important role in filtering your blood. When they fail, you are at much higher risk for a heart attack or stroke. (1)

Risk Factors & Strategies to Reduce Your Risk

The Factors Following have been Shown to Increase Your Risk for ESRD

Modifiable Factors: The following actions are controllable, and therefore should be avoided as consistently as possible. It is important to focus on these lifestyle changes in order to help offset the risk factors that are uncontrollable!

High Blood Pressure

High blood pressure is one of the main concerns for the progression of kidney disease. Diet and medication therapies will help maintain healthy levels (1)
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Red & Processed Meats

Albuminaria, or high protein in the blood, is a major risk for the progression of kidney disease. Red and processed meats exacerbate this issue the most. (2)
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Dark Colored Soda

High phosphorus consumption is a major threat to kidney failure. Dark sodas have a lot of phosphorus additive. Diet sodas further increase your risk! (3)
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Hyperkalemia (High Potassium)

Hyperkalemia is one of the leading causes of death due to kidney failure. Extreme levels can lead to a cardiac event. You can manage these levels with a proper diet. (4)
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High Sodium Intake

Sodium is one of the main enemies for your kidneys. Most diets are way too high in sodium and they cause blood pressure spikes, straining the kidneys. (5)
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Proton Pump Inhibitors (i.e. Prilosec)

Regular PPI use to treat gastroesophageal reflux disease (GERD) can increase the risk of ESRD progression. (9)
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Non-Steroidal Anti-Inflammatories (NSAIDs)

Regular use of NSAIDs, such as Advil or Aleve, increases your risk for kidney failure. (6)
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Tobacco Consumption

Like most health issues, tobacco use increases your risk for kidney failure. (7)
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Alcohol (>14 Drinks/Week)

If you consume 14 or more drinks per week, you are at an increased risk. (8)
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Obesity

Maintaining healthy weights will significantly reduce your risk of progression to kidney failure. (10)
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Non-Modifiable Factors: The following cannot be changed. However, these factors are important to know, so you can be cognizant of your lifestyle choices and understand the circumstances!

Family History

Those with a family history show increased risk of ESRD. (11)
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Older Age

Your risk for ESRD will increase with age. (12)
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African-American Descent

Those of African American descent are 3x more likely to develop ESRD. (13)
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History of Cardiovascular Issues & Conditions

History of stroke, heart disease, etc. all increase your risk (14)
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Kidney Stones

Prolonged obstructions of the urinary tract have been shown to increase risk of ESRD progression. (15)
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Diabetes

Diabetes is one of the major causes of kidney failure, especially with poor blood pressure control. (16)
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Nocturia

Consistently peeing at night is associated with a slight increased risk of progression. (18)
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Lupus

Individuals with lupus can develop lupus nephritis, which is a major concern for kidney failure mortality. (17)
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Help Reduce Your Risk For ESRD with these Choices

Regular Exercise

Cardio: 3-5 days/week Strength Training: 2 days/week Stretching/Yoga: 2 days/week (12)
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Proper Sleep

Getting too much or too little sleep is bad for your health. Getting 7-8 hours a night is ideal. (13)
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Dietary Factors

Daily Fruits & Veggies, Daily Whole Grains, Daily Low/Nonfat Dairy, Nuts 3-5x/Week, Daily Tea (especially green), Limit Red/Processed Meat (14)
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Symptoms & Prognosis

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Changes in how much you urinate
  • Decreased mental sharpness
  • Muscle twitches and cramps
  • Swelling of feet and ankles
  • Persistent itching
  • Chest pain, if fluid builds up around the lining of the heart
  • Shortness of breath, if fluid builds up in the lungs
  • High blood pressure (hypertension) that’s difficult to control

Adults with Severe Kidney Disease that Don't Know

5-Year Survival Rate

50%

2/5 adults with severe kidney disease do not even know they have kidney disease. At severe stages of kidney disease (3-4), there are a number of steps that can be taken to prevent progression to complete failure of the kidneys. With only a limited survival rate of patients with kidney failure, it is important you know what steps to take to prevent your case from progressing.

What to Expect on Dialysis

MedlinePlus Discusses End-Stage Renal Disease Treatment

Treatments for ESRD

  • Dialysis: The process of filtering your blood through a machine to carry out the function of your kidneys. Treatment is considered lifelong unless a kidney transplant is possible.
  • Kidney Transplant: If eligible, you can be put on a waiting list for a kidney transplant from an ideal donor.
  • ESRD is not reversible, so these interventions are 100% necessary. Kidney transplant has better long-term survival rates and should be strongly considered if you are eligible.


Additional Resources

National Kidney Foundation | NIDDK | Mayo Clinic