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End-stage renal disease, also known as renal failure or end-stage kidney disease, occurs when chronic kidney disease — the gradual loss of kidney function — reaches an advanced state. In end-stage renal disease, your kidneys are no longer able to work as they should to meet your body's needs.

Your kidneys filter waste and excess fluids from your blood, which are then excreted into your urine. When your kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up in your body. With end-stage renal disease, you need dialysis or a kidney transplant to stay alive.

Symptoms

Early along in chronic kidney disease, you may have no signs or symptoms. As chronic kidney disease develops into end-stage renal disease, signs and symptoms may include:

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Changes in your urination
  • Decreased mental sharpness
  • Muscle twitches and cramps
  • Swelling of feet and ankles
  • Persistent itching
  • High blood pressure

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

Risk Factors

Certain factors increase the risk that chronic kidney disease will progress more quickly to end-stage renal disease, including:

  • Diabetes with poor blood sugar control
  • Kidney disease that affects the glomeruli, the structures in the kidneys that filter wastes from the blood
  • Polycystic kidney disease
  • Kidney disease after a kidney transplant
  • High blood pressure
  • Tobacco use
  • African-American descent
  • Gender (males are more likely to have chronic kidney disease)
  • Older age

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