End-stage renal disease (ESRD) is kidney failure that requires dialysis or a kidney transplant if a patient is to continue living. As a result of ESRD, kidney function is stopped or severely impaired. Without working kidneys, fluids and waste products remain in the body. Their accumulation can lead to severe symptoms, as well as contribute to cardiovascular disease and other health conditions. ESRD is eventually fatal without treatment.

Healthy kidneys filter waste products, toxins and excess water from the blood. When the kidneys fail, these materials remain in the blood and proteins leak into the urine. Because of the protein loss and limited filtration, patients with ESRD are likely to experience edema (swelling), high blood pressure, reduced production of red blood cells and a buildup of wastes in the blood.

Diabetes is the leading risk factor for ESRD, and high blood pressure is second. Nearly half of all patients with ESRD also have diabetes, according to the American Diabetes Association (ADA). When diabetes and high blood pressure are combined, they account for about 60 percent of all cases of ESRD, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Other potential causes of ESRD include other chronic kidney diseases, heart failure and lupus (an autoimmune disease).

Diagnosis of ESRD is made with a combination of blood tests and urine tests. The presence of proteins in the urine is one of the strongest indicators of kidney damage. The diagnosis is confirmed through an indirect measure of the patient’s glomerular filtration rate.

Dialysis, the most common treatment for ESRD, replaces the impaired filtering ability of the kidneys. Eventually, most patients with ESRD will require a kidney transplant. The transplant gives the ESRD patient a healthy, functioning kidney from a cadaver or living donor. The new kidney cures ESRD and is likely to last between five and 15 years.

Kidney disease must be detected early to prevent progression to ESRD. Regular checkups can detect the presence of protein in the urine, an early indicator of kidney damage. Checkups are recommended at scheduled intervals for patients with diabetes, high blood pressure and other risk factors for kidney disease. Prevention can also be accomplished by controlling blood sugar (glucose), blood pressure and cholesterol levels. Additional preventive steps may involve limiting dietary salt, protein and alcohol intake.