End-stage renal disease


End-stage renal disease (ESRD) is the complete, or almost complete, failure of the kidneys to function. ESRD occurs when the kidneys are no longer able to function at a level needed for day-to-day life.

There are two different types of renal failure. Acute end-stage renal failure occurs abruptly and is potentially reversible. Chronic kidney failure progresses slowly over months. It usually leads to permanent, end-stage renal failure. A person may have gradual worsening of kidney function, or kidney insufficiency, for 10 to 20 years or more before progressing to ESRD. Patients who have reached this stage need dialysis or a kidney transplant.


The most common causes of ESRD in the U.S. are diabetes and high blood pressure.

Diabetic kidney disease is one of the complications of diabetes. The function of healthy kidneys is to act as filters that keep the bloodstream clean. When kidneys are damaged by the high blood sugar levels of diabetes, waste and fluids build up in the blood, instead of being eliminated.


The symptoms for acute and chronic renal failure may be different. The following are the most common symptoms of acute and chronic renal failure. However, each individual may experience symptoms differently:

  • General ill feeling and fatigue
  • Generalized itching (pruritus) and dry skin
  • Headaches
  • Weight loss without trying
  • Loss of appetite
  • Nausea

Other end-stage renal disease symptoms that may develop include:

  • Abnormally dark or light skin and changes in nails
  • Bone pain
  • Brain and nervous system symptoms
    • Drowsiness and confusion
    • Problems concentrating or thinking
    • Numbness in the hands, feet, or other areas
    • Muscle twitching or cramps
  • Breath odor
  • Easy bruising, nosebleeds, or blood in the stool
  • Excessive thirst
  • Frequent hiccups
  • Low level of sexual interest and impotence
  • Menstrual periods stop (amenorrhea)
  • Sleep problems, such as insomnia, restless leg syndrome, or obstructive sleep apnea
  • Swelling of the feet and hands (edema)
  • Vomiting, especially in the morning

The symptoms of acute and chronic end-stage renal failure may resemble other conditions or medical problems. Always consult a physician for a diagnosis.