End Stage Renal Disease: Causes, Symptoms, Treatment and Cost

End-Stage Renal Disease (ESRD) is the inability of the kidneys to function completely or almost completely. It is the last stage of chronic kidney disease and requires dialysis or a kidney transplant to maintain life. People with ESRD cannot filter waste from their blood and must rely on dialysis or a transplant to keep them alive.

There are three main types of ESRD:

• Chronic Kidney Disease (CKD): CKD is a chronic illness that worsens with time. It may affect persons of all ages, although it is most prevalent among the elderly.
• Acute Kidney Failure (AKF): AKF occurs suddenly and can be caused by a variety of factors such as infections or injury to the kidneys.
• End-Stage Renal Failure (ESRF): ESRF is the most advanced form of renal disease and occurs when both kidneys have completely stopped functioning due to severe damage or illness.

The following are the primary contributors to end-stage renal disease (ESRD):

• Diabetes
• High blood pressure
• Glomerulonephritis (an inflammation of the tiny filters in the kidneys).
• Other causes include inherited kidney diseases, autoimmune diseases, certain medications, and blockages of the urinary tract.

Common symptoms include:

• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Weight loss
• Muscle cramps
• Swelling of the limbs (edema)
• Difficulty concentrating
• Sleep disturbances
• Decreased urine output.
• Additionally, ESRD can cause symptoms related to high levels of toxins in the blood such as confusion and difficulty breathing.

Even while ESRD cannot be treated, there are steps you may do to lessen the likelihood that you will acquire the illness. These include:

• Exercising on a consistent basis
• Keeping a healthy weight as one's goal
• Avoiding smoking and minimising alcohol intake
• Keeping blood pressure and diabetes under control
• Additionally, regular checkups with your doctor can help to identify any kidney problems early on so that they can be treated promptly.

In order to diagnose ESRD, tests and procedures such as urine tests, kidney biopsies, imaging scans (CT/MRI), and blood tests are necessary.

• Urine tests: They measure waste products such as creatinine that have been filtered out by the kidneys.
• Kidney biopsies: They entail extracting a tiny tissue sample from the kidney and examining it under a microscope to check for any abnormalities or damage that may have occurred.
• Blood tests: They help to look at levels of substances like potassium and phosphorus which are involved in maintaining proper body function but become imbalanced when ESRD is present.
• CT Scan: A CT scan may be used to assess kidney size and function in an individual with known ESRD. In addition to this, it may be used to identify any obstructions or anomalies in the urinary system that may be the root cause of ESRD.
• Ultrasound: An ultrasound is a noninvasive medical imaging test that uses sound waves to create pictures of the kidneys and other organs in the body. It is used to assess the size, shape, structure, and functioning of the kidneys in patients with end-stage renal disease (ESRD).
• Glomerular filtration rate (GFR) test: It assesses the efficiency with which your kidneys remove waste products and toxins from your circulation.

End Stage Renal Disease (ESRD) can lead to a range of complications, including high blood pressure, anaemia, fluid retention, bone disease, cardiovascular disease, infection.

Herbal Remedies: Herbal remedies have been used for centuries to treat various ailments including kidney disease and ESRD.

Some popular herbs used in Ayurvedic medicine include ashwagandha, shatavari root, guduchi stem, amalaki fruit, bhringaraj leaf extract, and punarnava root extract which all possess anti-inflammatory properties that may be beneficial for ESRD patients.

In end stage renal disease, patients should eat a well-balanced diet that is low in sodium, phosphorus, and potassium, and high in fibre.

It is advised that you eat foods like fruits, vegetables, whole grains, low-fat dairy products, and proteins that are low in fat.

Patients who have reached the end stage of renal disease (ESRD) are advised to stay away from foods that are high in sodium, phosphorus, and potassium.Processed meats, canned soups and vegetables, cheese, almonds, peanut butter, chocolate, tinned fruits and liquids are examples.

They should also minimise their consumption of animal proteins such as red meat and eggs.

Treatment for ESRD includes:

• Lifestyle changes: These include eating a healthy, balanced diet low in sodium and protein, drinking plenty of fluids, taking prescribed medications, exercising regularly, and avoiding smoking or alcohol.
• Medications: Medications may be prescribed depending on the specific needs of the patient. Additionally, injections of erythropoietin or iron may be necessary to help treat anaemia associated with end stage renal disease.
• Peritoneal dialysis: This type of dialysis uses your peritoneal membrane to filter out waste and extra fluids from your body. It involves filling your abdomen with a special solution called dialysate, which helps absorb toxins and excess fluid that are in your blood.
• Hemodialysis: Hemodialysis is also an option for treating ESRD. In hemodialysis, you will use a machine to filter out toxins and extra fluids in your blood that are not being removed by your kidneys. It requires access to an artery and vein so that the machine can be connected directly to your bloodstream for filtering purposes.
• Kidney transplant: A healthy, working kidney from a live or dead donor is transplanted into the body of the patient during a kidney transplant.
• Renal Artery Angioplasty: Renal artery angioplasty is a procedure used to open up narrowed or blocked renal arteries due to plaque buildup or other narrowing conditions of the arteries leading to the kidneys.

To identify and treat ESRD, patients should see a nephrologist, a specialist who specialises in the diagnosis and treatment of renal problems. A nephrologist will perform tests to determine how far the kidney function has declined, as well as recommend possible treatments such as dialysis or a kidney transplant.

The best medicines for End Stage Renal Disease (ESRD) depend on the individual patient's medical condition and other factors. Generally, the medications used to treat ESRD include:

• Diuretics: These drugs help the body eliminate excess fluid and reduce swelling in the limbs and face.
• ACE inhibitors: These drugs lower blood pressure by blocking a hormone in the body that causes blood vessels to constrict. They may also be able to delay the course of renal disease.
• Iron supplements: Some patients with ESRD may require supplemental iron to help their bodies make enough red blood cells, which carry oxygen throughout the body.
• Phosphate binders: Patients with ESRD often have high levels of phosphate in their blood, which can be dangerous for their health if left unchecked. Phosphate binders are medications that reduce phosphate levels by binding them up so they can't be absorbed by the kidneys or intestines.
• Vitamin D supplements: Vitamin D helps regulate calcium and phosphorus levels in your body, both of which are important for healthy bones and teeth as well as keeping your muscles working properly.
• Antibiotics: Patients with ESRD may receive antibiotics if they have a bacterial infection or inflammation caused by bacteria that may lead to complications. Examples of antibiotics used for ESRD include amoxicillin, ciprofloxacin, and vancomycin.

The recovery time for End Stage Renal Disease (ESRD) is highly dependent on the individual and the underlying cause of the condition. Recovery times can vary from months to years depending on the severity of ESRD, and some people may never fully recover.

In general, those who receive dialysis or a kidney transplant are likely to have an improved quality of life and a more positive outlook for their future.

No, the results of treatment for end stage renal disease (ESRD) are not permanent.

Treatment for ESRD is designed to help manage the disease and provide relief from symptoms, but it does not cure or reverse the underlying condition.

The post-surgical treatments for end stage renal disease (ESRD) depend on the type of procedure that was done. Generally, the treatment guidelines focus on managing and controlling complications that may arise after surgery, such as infection and bleeding.

For patients who underwent kidney transplantation, the post-surgical treatment may include medications to prevent rejection of the new kidney, monitoring of blood pressure levels, monitoring of blood chemistry levels, immunosuppression therapy to reduce the risk of rejection, and close follow-up with a nephrologist or transplant specialist.

Patients who underwent dialysis as part of their ESRD treatment may be prescribed medications such as antihypertensives (to lower blood pressure) and diuretics (to reduce fluid retention). Dialysis patients should also monitor their diet for adequate nutrition and should be evaluated regularly by their nephrologist for any side effects from dialysis or other treatments.

Dialysis is the most commonly used treatment for ESRD, and the cost of this treatment can range from around Rs 10,000 to Rs 50,000 per month.In addition to dialysis there are also alternative treatments such as kidney transplantation which can cost anywhere from Rs 1 lakh to Rs 5 lakhs.

Other costs associated with ESRD treatments such as medications and hospital stays can also add up significantly.

Overall, the cost of treating ESRD in India can be quite high and it is important for patients to talk to their doctors about available options so that they can make an informed decision about their care.

The most common side effects of End Stage Renal Disease treatments include fatigue, nausea, vomiting, loss of appetite, and muscle cramps. Other potential side effects may include anaemia, infection, electrolyte imbalance and changes in blood pressure.

If you are suffering from any complications relating to End Stage Renal Disease (ESRD) then you should consult a doctor nearby as they can cause complications like high blood pressure, anaemia, fluid retention, etc. in which treatment courses can range from a few months to years depending on the severity of the situation.