End Stage Renal Disease (ESRD)

The last stage of kidney disease is the most serious. The kidneys can no longer function effectively to remove waste and excess water from the body.

Acute or sudden kidney failure is a medical emergency. However, most often kidney failure is gradual.  If your kidney function is declining your doctor will track the kidney function, recommend treatment to help keep it from worsening, and if needed help you prepare for hemodialysis.

What is end stage renal disease?

End stage renal disease also is called end stage kidney disease. This is when your kidneys are functioning below 10 percent, and can no longer filter waste and excess fluid from your body.

End stage renal disease symptoms

Your body will most likely not produce urine, or very little urine, if your kidneys are failing.

Kidney failure symptoms can include:

  • Fatigue
  • Inching and dry skin
  • Numbness and tingling
  • Headache
  • Unexplained weight loss
  • Nausea
  • Loss of appetite
  • Bone pain
  • Muscle cramps
  • Little to no urine output
  • Urinary tract infections (UTIs)

Kidney failure is not limited to these symptoms. Contact your provider as soon as possible if you have symptoms of chronic kidney disease.


End stage kidney disease almost always follows chronic kidney disease. End stage kidney disease is known as Stage 5 chronic kidney disease.

Diabetes and high blood pressure are the most common causes of end stage kidney disease. But chronic kidney disease and end stage renal disease can be caused by a number of other things:

  • Glomerulonephritis
  • Polycystic kidney disease
  • Urinary tract blockage
  • Kidney infection

Managing these conditions is the best way to avoid end stage renal disease. Consult your provider about what you can do to prevent kidney failure.

Blood and urine tests can determine how your kidneys are functioning. A patient is diagnosed with end stage renal disease if kidney function falls under 10 percent.

Creatinine levels in blood and urine determine if the kidneys are filtering blood.

Kidneys are not functioning well if there is too much creatinine built up in the blood and too little being excreted from the body in the urine.

It is critical to get treatment for end-stage kidney disease. People with end-stage kidney disease cannot live without treatment.

There are two ways to treat end stage renal disease: dialysis or kidney transplant.

  • Dialysis is a procedure that filters a patient’s blood for them. This can be done by connecting an artificial kidney or filter to a patient’s arm, leg, or neck (hemodialysis).
  • Another option for hemodialysis is a permanent tube in a patient’s belly. This will create access for a solution that goes into your abdominal cavity. This solution collects waste and is then taken out and disposed of.
  • A kidney transplant replaces a nonfunctioning kidney with a new one. Donors, alive or deceased, can provide the kidney for the transplant if they qualify.
Maine Medical Center has Maine's only kidney transplant program. Patients can be evaluated and put on the waiting list for a kidney. When made available, providers will perform the transplant right at Maine Medical Center.