End-stage Kidney Disease (ESKD) - Symptoms & Causes

What is end-stage kidney disease?

End-stage kidney disease (ESKD), also known as kidney failure, marks the final phase of chronic kidney disease (CKD) where the kidneys can no longer perform their necessary functions independently. At this stage, dialysis or a kidney transplant becomes essential for survival.

What are the symptoms of end-stage kidney disease?

Symptoms of ESKD may occur due to the accumulation of waste products and/or excess water in the body as the kidneys lose their filtering ability. These symptoms typically become more apparent as the disease progresses to its final stage.

An important symptom of ESKD is the change in amount of urine output. This can manifest as a significant reduction or, in some cases, a complete cessation, of urine production, which is medically known as anuria. This symptom is particularly noticeable because it directly relates to the primary function of the kidneys -- the filtration and excretion of bodily wastes through urine.

Other common symptoms of ESRD include:

• Fatigue: This is one of the most commonly reported symptoms, resulting from anaemia and the general build-up of toxins in the blood that the kidneys can no longer filter out.
• Swelling or edema: Due to the kidneys' failure to remove excess fluid from the body, swelling is common in the legs, ankles, feet, and sometimes the hands and face.
• Muscle cramps: Imbalances in electrolytes, such as calcium and phosphorus, can cause muscle cramps, particularly in the legs.
• Nausea and vomiting: As waste products build up in the bloodstream, they can cause non-specific symptoms like nausea and vomiting.
• Mental confusion and difficulties with alertness: Toxin build-up can also affect brain function, leading to issues with concentration, drowsiness, and other cognitive impairments.

What causes end-stage kidney disease?

The leading causes of ESKD are diabetes and high blood pressure. Other causes or risk factors include:

• Chronic glomerulonephritis
• Polycystic kidney disease
• Prolonged obstruction of the urinary tract
• Recurrent kidney infection
• Other chronic illnesses such as lupus and rheumatoid arthritis

What are the complications and related diseases of end-stage kidney disease?

The complications associated with end-stage renal disease are numerous and often severe, impacting various systems and functions within the body. They include:

• Cardiovascular disease
• Anaemia
• Bone disease
• High blood pressure
• Fluid overload
• Acidosis (excessive acidity of blood and body tissues)
• Potassium, calcium, and phosphorus imbalance
• Malnutrition

How do you prevent end-stage kidney disease?

Prevention strategies focus on controlling diseases that can lead to ESKD, such as diabetes and hypertension. This includes maintaining healthy blood sugar levels, managing blood pressure, leading a healthy lifestyle with the appropriate diet and exercise, and regular check-ups to monitor kidney function, especially for those at higher risk.