End stage kidney or renal disease is a critical medical condition when the kidney stops functioning completely. It may be a gradual process where problems in kidney or chronic kidney disease gets severe and reaches an advanced level. End-stage kidney disease is also referred as end stage renal disease. In some cases it might be a sudden process but such circumstances are not very common.
Kidney is a vital organ of our body that works like a filter and thus helps in purifying blood by absorbing waste particles. In an event of failure of kidney, the waste particles and electrolytes are not filtered out from the blood. This leads to accumulation of unwanted waste materials in body.
In an event of an end stage kidney or renal disease, a kidney transplant is the only permanent option to allow the patient to survive. He/She may also opt for dialysis but it is a temporary solution as it needs to be carried out at a regular interval. An individual may also opt for conservative care methods that can help in managing symptoms and make life better until you can survive with kidney failure.
Causes of End Stage Kidney or Renal Disease
End stage kidney or renal disease is usually an advanced stage of a disease that affects kidney, that gradually affects the functioning of kidney and eventually resulting into complete loss of its functionality over a period of several months or years.
The following factors or conditions can lead to end stage kidney or renal disease:
- Frequent occurrence of infections in the kidney, a medical condition referred as pyelonephritis.
- Inflation in the tubules of the kidney or in the structure that surrounds them, a medical condition referred as Interstitial nephritis.
- Diabetes of Type 1 or type 2.
- A medical condition called Vesicoureteral Reflux where urine tends to flow back into kidneys can also cause end stage kidney or renal disease.
- Another disease which can cause end stage kidney or renal disease is polycystic kidney disease.
- Unregulated high blood pressure.
- Inflation in the filtering units of the kidney called as glomeruli and the medical condition is referred as Glomerulonephritis.
- Some other kidney problems such as stones, enlarged prostate, kidney cancer etc… that can cause consistent obstruction in the urinary tract.
Symptoms of End Stage Kidney or Renal Disease
A chronic kidney disease may not show any signs of symptoms during the early stage. However, as the condition of the kidney gets worse and reaches to the advanced level of end stage kidney or renal disease, the following signs and symptoms occur:
- Not feeling hungry.
- Feeling tired or lacking energy in body.
- Unable to sleep.
- Alteration in the amount of urine from normal.
- Unable to concentrate on your work mentally.
- Occurrence of cramps and twitches.
- Swelling in ankles and feet.
- Itching in different parts of body.
- Pain in the chest if the fluids start to accumulate in the area around heart.
- Unable to breath properly if the there is accumulation of fluids around lungs.
- Rise in the blood pressure without any possible reasons is also a symptom of end stage kidney or renal disease.
Most of the signs and symptoms that are associated with kidney problems are general and thus it is hard identify the actual medical condition that might be responsible for the symptoms. Moreover, kidney can manage minor problems and thus no signs and symptoms appear until the problem gets worse or irreversible.
Tests to Diagnose End Stage Kidney or Renal Disease
End stage kidney or renal disease can be detected by the follow tests and medical examinations:
- The primary process to identify the possibilities of end stage kidney or renal disease is to take into consideration any family history of problems related to kidney. A doctor talks to the patient about the signs and the symptoms to get a hint of the condition.
- The doctor carries out complete physical examination including measurement of blood pressure, weight, height etc… An expert also checks for any problems with the blood vessels or heart.
- Biopsy of kidney tissue is also used for diagnosing end stage kidney or renal disease. In this test, a small tissue of the kidney is extracted and observed under the microscope to identify possible problems in the structure and functioning of the cells.
- Urine Test is mainly performed to detect the level of the protein albumin present in urine as any increase in its concentration is a reflection of possible kidney problems.
There are various types of imaging tests that help in creating an image of the kidney or any other part of the body under observation making t easier for a doctor to identify any problems in the structure. Imaging tests includes basic X-rays as well as advanced MRI scans and CT scans that use electromagnetic waves to create a digital image and they can be helpful in proper diagnosis.
- Blood tests involve measurement of the amount of waste such as urea present in the blood as higher wastes reflects the improper functioning of the kidney.
Some tests may be required to be carried out at a regular interval to monitor the changes in the condition of the kidney.
Treatment for End Stage Kidney or Renal Disease
End stage kidney or renal disease can be treated in the following ways:
- Kidney transplant.
- Supportive care.
Dialysis to Treat End Stage Kidney or Renal Disease
Dialysis for end stage kidney or renal disease is an artificial process similar to the filtration process that occurs in a normal kidney. It helps in getting rid of waste materials from the blood, thus preventing the accumulation of harmful substances in blood and managing proper level of electrolytes to keep blood pressure normal. There are two possible types of dialysis: hemodialysis and peritoneal dialysis. However, dialysis needs to be carried out at regular intervals as long as patient survives.
Kidney Transplant for End Stage Kidney or Renal Disease
Kidney Transplant is a sort of permanent solution for end stage kidney or renal disease if it does not results into any complications. It is a surgical procedure in which the non-working kidney of the patient is replaced surgically with a healthy kidney obtained from a living or dead person called as donor. As it is a permanent option, it is the most preferred treatment option as long as a patient can afford the cost of treatment.
Kidney transplantation is a long process that first requires finding a right donor. A donor can be a living or dead person who has a functional kidney. There are various criteria for the right donor. Once you have a kidney from the donor, it is surgically fitted in place of the non-functional kidney and connected properly to ureter and blood vessels. A person is kept under observation in the hospital until he recovers enough to go back to home. A person needs to take some medications following the surgery and also take precautions in the routine activities. These medications helps in eliminating chances of rejection of kidney by your immune system. Once the kidney starts to function normally after a kidney transplant, the patient can lead a normal life without any need of dialysis.
Supportive Care for End Stage Kidney or Renal Disease
Supportive care methods for end stage kidney or renal disease alone cannot prevent complications including death but when combined with other treatment options can make things easier. It helps in relieving from some symptoms to a certain level and make a patient feel better even without other treatment options.
What is the Life Expectancy for End Stage Kidney or Renal Disease?
If a person does not opt for a kidney transplantation or dialysis to manage kidney problems, they continue to get worse and end at stage 5 or end stage kidney or renal disease after which the person can survive only for a few weeks without treatment.
How Long Can You Live With End Stage Kidney Failure?
A person with end stage kidney or renal disease can only survive for a few weeks without Dialysis or Kidney Transplantation. The chances of survival increases significantly with a kidney transplant. About 23 percent of patients undergoing kidney transplantation can survive for about 10 years while the rest have an average life of 4.25 years after the surgery. Dialysis is a frequent process and it can support life for as long as it is continued. Once the dialysis is discontinued, a patient cannot survive for more than 4 weeks in most cases.
Prevention of End Stage Kidney or Renal Disease
A healthy lifestyle can helps in reducing the chances of kidney diseases. Some of the ways to prevent end stage kidney or renal disease are exercising regularly, reducing the intake of salt in your diet, stop smoking and drinking alcohol.
Risk Factors for End Stage Kidney or Renal Disease
All such factors and medical conditions that are responsible for a chronic kidney disease can increase the risk of end stage kidney or renal disease. The common risk factors are as follows:
- High blood pressure.
- Being male.
- An un-controlled form of Diabetes.
- Intake of tobacco in any form.
- Any type of kidney disease that can harm or affect the functioning of filtering units of kidneys called as glomeruli.
- Polycystic kidney disease.
- Belonging to African-American descent.
- Complications resulting from a kidney transplant is also a risk factor for end stage kidney or renal disease.
- National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Kidney Disease Statistics for the United States. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease