What You Need to Know about End Stage Renal Disease (ESRD)

Hearing your kidneys have failed is not an easy thing to digest and can often come as a surprise since symptoms usually don’t appear until kidney damage has occurred. If you’ve recently been diagnosed with end stage renal disease (ESRD), it’s important to know that there are treatment options that can help people thrive and live a full life.

ESRD is the final stage of kidney disease, when your kidneys have little to no function. In this stage, your kidneys can no longer support your body’s need to filter waste and excess fluids from your blood. Your kidneys play a vital role in your health, which means that ESRD requires treatment to prolong life and keep you feeling healthy.

There are several underlying causes of chronic kidney disease that reduce your kidney function over time, leading to ESRD. Some of these causes include:

• Diabetes
• High blood pressure
• Glomerulonephritis 
• Heart disease
• Frequent urinary problems, such as kidney stones¹
• Polycystic kidney disease

If your kidneys have failed, you may experience the following symptoms. Talk with your doctor if you have any questions or concerns.

• Nausea and vomiting
• Fatigue
• Shortness of breath
• Swelling in your hands, legs, and feet
• Mental confusion
• Metallic taste in mouth
• Muscle cramps 
• Trouble sleeping¹
• Too much or too little urine¹
• Itchy or irritated skin

If you’ve recently been diagnosed with ESRD by a nephrologist, a doctor who specializes in kidney disease, you may be wondering what’s next. You may be overwhelmed with new information and unsure of how to proceed. These 5 steps can help you take control of your health after receiving an ESRD diagnosis.

1. Understand your options. A kidney doctor, also known as a nephrologist, can help you understand your options when it comes to living with ESRD. You will discuss treatment options including: transplant, home peritoneal dialysis, home hemodialysis, and in-center hemodialysis. You'll need to make a decision about ESRD treatment, and your kidney doctor will help determine a treatment plan that is best for your unique lifestyle and health needs. Along with your care team, your nephrologist will support you throughout your kidney care journey and work together with you so you can take control of your health.
2. Ask about medications. After an ESRD diagnosis, you may need to take certain dialysis-related medications and vitamins to help manage your health. If you have other health conditions, such as diabetes or high blood pressure, your care plan may include additional medications prescribed by your doctor. Talk to your nephrologist about medications you currently take and which medications you might need to take. Keep a list of your medications including vitamins and supplements and make sure your nephrologist is aware of any medication changes made by other doctors. 
3. Talk to your dietitian about an end stage renal disease diet and eating kidney-friendly meals. After an ESRD diagnosis, your kidneys are no longer able to function as they should, meaning your kidneys can’t filter excess waste from your blood. To feel your best, you may need to adjust your intake of certain foods. Fortunately, following a kidney-friendly diet doesn’t mean you have to miss out on the flavors you love. 
4. Meet with your insurance coordinator. Talk to your insurance coordinator to explore your health coverage options and select an insurance plan that provides the best possible coverage for you. Your insurance coordinator is your guide to helping you manage dialysis costs. 
5. Build your support network. Adjusting to life with ESRD can take time, but you don’t have to do it alone. Reach out to friends and family who will support you along your journey and get comfortable talking about dialysis with them. If transplant is an option you are considering, there are support tools to help you in discussing with your support team. 

Your nephrologist and care team are available to answer any questions you have about ERSD so make sure to talk with them about any concerns or questions you have. Not sure what to ask? Use our ESRD Questions handout to start important conversations with your nephrologist and care team. 

There are several end stage renal disease treatment options. The key is to work with your doctor and care team to determine the treatment that fits best into your schedule and day-to-day life.

Kidney transplant

A kidney transplant is the best treatment option for providing natural kidney function and, therefore, generally the most effective treatment for ESRD. During the kidney transplant surgery, a person with kidney disease receives a new kidney — either from a living or deceased donor. 

Dialysis

Dialysis is a life-sustaining treatment that takes the place of healthy kidney functions. Dialysis filters waste, toxins, and excess fluid from your body in place of your kidneys so you can live a full, productive life. 

There are 2 types of dialysis to choose from:

• Peritoneal dialysis (PD) — naturally filters waste from your blood using blood vessels in the lining of your abdomen, called the peritoneum. The dialysate flows through your PD catheter into your abdominal cavity, where it absorbs excess waste and toxins, and then drains back out. Through this method, your blood is filtered without leaving your body. This may be a good option if you have a planned start to dialysis and some remaining kidney function. And after being trained by your care team, treatments are performed by you or your care partner in the comfort of your home. 
• Hemodialysis (HD) — filters your blood through a dialyzer, also known as an artificial kidney. This treatment requires a hemodialysis access where your blood can safely flow from your body to the machine to get cleaned and then back to your body. Home Hemodialysis is performed in the comfort of your home and on your own set schedule. In-center dialysis is performed by a staff of nurses and technicians in one of our dialysis centers. 

Taking care of your health — both physically and mentally — is important to helping you keep up with the life you love. Below are a few tips to help you feel your best with ESRD:

1. Take your medications as prescribed. Taking your dialysis medications is important to feeling your best, especially if you are managing multiple health conditions while on dialysis. 
2. Eat well and exercise. Following a kidney-friendly diet and exercising regularly will help you maintain a healthy weight, while also giving you more energy to do the things you love. 
3. Manage stress. Part of staying healthy while living with kidney disease is caring for your mental well-being. It’s understandable — and common — to feel stressed. Fortunately, you don’t have to manage it alone. Talk to your care team if stress is causing you problems. 
4. Get vaccinated. Protect yourself against viruses and potential infections by getting vaccinated as recommended by your doctor, especially for pneumonia, the flu, and COVID-19.  
5. Practice good hygiene. Good hygiene is key to avoiding infection when living with kidney disease. Washing your hands and caring for your access can help you stay healthy. To care for your access site, follow the instructions from your doctor and check your access site regularly.

Check in with your doctor and care team often, letting them know of any significant changes in how you are feeling. They’ll work with you to develop a care plan that fits your unique lifestyle and keeps you healthy.

An ESRD diagnosis may require certain lifestyle adjustments, but there are several treatment options that can help you take back control of your health. Your nephrologist and care team will help you develop a care plan that helps you live a full and active life and keep doing the things you enjoy with the people you love. Take an active role in your health by asking questions so you know what to expect and what you can do to feel your best.