End stage kidney disease (ESKD) is the final stage (stage five) of chronic kidney disease (CKD). At this stage, kidneys function at only 10 to 15 percent of their normal capacity. Kidneys play a vital role in overall well-being, including filtering waste, regulating fluid, balancing electrolytes, and producing hormones. With ESKD, dialysis or a kidney transplant is essential for survival.
Fully functional kidneys cleanse the blood of waste and excess fluid, excreting them as urine. In ESKD, kidneys are ineffective at removing these substances, leading to their buildup in the body, resulting in a condition called uremia. Insufficient fluid removal causes tissue swelling, known as edema, and can elevate blood pressure.
Electrolytes like magnesium, sodium, and potassium are essential minerals found in food. Balanced levels are crucial for health. ESKD-affected kidneys cannot regulate these electrolyte levels, potentially leading to issues. High sodium levels can cause water retention in tissues. Excess potassium can disrupt heart rhythms, even causing cardiac arrest. Imbalances in magnesium can affect the heart and mental state.
Healthy kidneys produce hormones like parathyroid hormone (PTH), which activates vitamin D into calcitriol, aiding calcium absorption. Inadequate calcium absorption leads to weak bones. Another kidney hormone is erythropoietin, which prompts red blood cell production for oxygen transport. Low red blood cell counts result in anemia, causing weakness and fatigue.
Kidneys produce renin, an enzyme regulating sodium, potassium, and blood pressure. When blood pressure drops, renin initiates a chemical reaction that produces angiotensin, narrowing blood vessels and raising blood pressure. Angiotensin also signals adrenal glands to release aldosterone, prompting salt retention and fluid preservation. ESKD may lead to excessive renin production, causing challenging hypertension.
Regular dialysis treatment, adherence to a renal diet, and taking prescribed medications are crucial for effectively managing ESKD. If diagnosed with end stage kidney disease, following your healthcare team’s advice is essential for proper treatment.
