Kidneys are vital organs that play a crucial role in maintaining overall health. However, when kidney function drops to below 10-15% of its normal capacity, they struggle to perform essential tasks, such as eliminating waste and excess fluids from the blood. End stage renal disease (ESRD) marks the final stage (stage five) of chronic kidney disease (CKD). In cases where CKD, polycystic kidney disease (PKD), or other kidney conditions progress to ESRD, treatments like dialysis or kidney transplantation become necessary for survival.
Normally, healthy kidneys efficiently filter wastes and excess fluid from the blood, expelling them as urine. In ESRD, kidney function significantly diminishes, causing waste and fluid buildup in the body, leading to a condition called uremia. This buildup can make you feel unwell. Additionally, inadequate fluid removal can result in tissue swelling known as edema and elevate blood pressure.
Electrolytes, including magnesium, sodium, and potassium, are essential minerals found in the foods you consume and are critical to good health. However, in ESRD, the kidneys cannot regulate these electrolyte levels properly, leading to disruptions in various bodily functions. Excessive sodium may cause tissues to retain water, while elevated potassium levels can lead to abnormal heart rhythms, potentially resulting in cardiac arrest. Insufficient magnesium can affect your heartbeat and mental state, while an excess can leave you feeling weak.
Healthy kidneys produce specific hormones, including parathyroid hormone (PTH), which activates vitamin D into calcitriol, aiding calcium absorption. In ESRD, the body’s ability to absorb calcium diminishes, leading to weakened bones that are prone to fractures. Another hormone, erythropoietin, signals the body to produce red blood cells, responsible for oxygen transport. Low red blood cell counts, often seen in ESRD, result in anemia, causing weakness and fatigue.
Kidneys produce the enzyme renin, which helps regulate sodium, potassium, and blood pressure. In response to low blood pressure, renin triggers a chain reaction that produces angiotensin, causing blood vessels to constrict and raising blood pressure. It also prompts the release of aldosterone, instructing the kidneys to retain sodium and excrete potassium, increasing blood volume. In ESRD, kidneys may overproduce renin, leading to challenging-to-control hypertension.
Managing ESRD involves regular dialysis treatment, adhering to a renal diet, and taking prescribed medications. If you have been diagnosed with end stage renal disease, it is crucial to follow your healthcare team’s advice regarding treatment.
