ESRD

Each year in the United States, more than 50,000 people are diagnosed with end-stage renal
disease (ESRD), a serious condition in which the kidneys fail to rid the body of wastes. ESRD is
the final stage of a slow deterioration of the kidneys, a process known as nephropathy.

What causes End-Stage Renal Disease?

Diabetes is the most common cause of ESRD, resulting in about one-third of new ESRD cases.
Even when drugs and diet

are able to control diabetes, the disease can lead to nephropathy and ESRD. Most people with
diabetes do not develop nephropathy that is severe enough to cause ESRD. About 15 million people
in the United States have diabetes, and about 50,000 people have ESRD as a result of diabetes.
Other causes include:
• Interstitial Nephritis - 2.9 percent

• Polycystic Kidney Disease - 2.9 percent

• Glomerulonephritis - 11.4 percent

• Other Causes - 18.1 percent

• High Blood Pressure - 28.8 percent

• Diabetes - 35.9 percent

Is there a cure or treatment for ESRD?

ESRD patients undergo either dialysis, which substitutes for some of the filtering functions of
the kidneys, or transplantation to receive a healthy donor kidney. Most U.S. citizens who
develop ESRD are eligible for federally funded care. In 1994, the Federal Government spent
about $9.3 billion on care for patients with ESRD.

Who is most at risk for ESRD?

 African Americans and Native Americans develop diabetes, nephropathy, and ESRD at rates
higher than average. Scientists have not been able to explain this. Nor can they fully explain the
interplay of factors leading to diabetic nephropathy--factors including heredity, diet, and other
medical conditions, such as high blood pressure. They have found that high blood pressure and
high levels of blood sugar increase the risk that a person with diabetes will progress to ESRD.

Also, people with diabetes who have high blood pressure, or hypertension, have increased odd
of developing kidney disease. Both a family history of hypertension and the presence of
hypertension appear to increase chances of developing kidney disease. Hypertension also
accelerates the progress of kidney disease where it already exists.

The list of signs and symptoms mentioned in various sources for End-stage renal disease
includes the 10 symptoms listed below:

• Reduced urine
• Total lack of urine
• Nausea
• Vomiting
• Uremia - causing various symptoms of uremia:
o Drowsiness
o Confusion
o Seizures
o Coma

Complications list for End-stage renal disease:

The list of complications that have been mentioned in various sources for End-stage renal
disease includes:

• Uremia
• Shock
• Seizures
• Coma
 Prognosis

Deaths and Mortality Rates

Deaths from End-stage renal disease: 76,584 deaths in patients undergoing treatment in the
USA 2001 (United States Renal Data System 2003 Annual Data Report, 2003)

Estimated mortality rate for End-stage renal disease from prevalence and deaths
statistics:

• Deaths: 76,583 (USA annual deaths calculated from this data: 76,584 deaths in
patients undergoing treatment in the USA 2001 (United States Renal Data System 2003
Annual Data Report, 2003))
• Incidence: 392,022 (USA prevalence calculated from this data: 392,023 people in the
USA 2001 (United States Renal Data System 2003 Annual Data Report, 2003)
• 19.5% (ratio of deaths to prevalence).
• See also Deaths and End-stage renal disease and Overview of End-stage renal
disease.

Estimated mortality rate for End-stage renal disease from incidence and deaths
statistics:

• Deaths: 76,583 (USA annual deaths calculated from this data: 76,584 deaths in
patients undergoing treatment in the USA 2001 (United States Renal Data System 2003
Annual Data Report, 2003))
• Incidence: 89,252 (USA annual incidence calculated from this data: 89,252 new
cases (NIDDK)
• 85.8% (ratio of deaths to incidence).

Following is a list of causes or underlying conditions (see also Misdiagnosis of

underlying causes of End-stage renal disease) that could possibly cause End-stage renal
disease includes:

• Kidney disease - obviously ESRD starts as early kidney disease.

• Diabetic nephropathy - 43.2% (NIDDK) of kidney failure is due to diabetes; most
common cause; 35.9% of cases (NHWIC).
• Chronic kidney failure - ESRD is by definition the last state of chronic kidney failure
• Hypertension - 23% of cases (NIDDK); 28.8% cases (NWHIC)
• Glomerulonephritis - 12.3% of cases (NIDDK); 11.4% cases (NWHIC)
 • Polycystic kidney disease - 2.9% of cases (NIDDK, NWHIC)

List of Risk Factors for End-stage renal disease

The list of risk factors mentioned for End-stage renal disease in various sources includes:

• Kidney disease
• Diabetes
• Hypertension
• Family history of hypertension