Irreversible loss of the function of both kidneys, which is life-threatening
- Age, gender, genetics, and lifestyle as risk factors depend on the cause
End-stage kidney failure occurs when there is a permanent loss of over 90 per cent of kidney function. As a result, the kidneys are unable to filter waste products and excess water out of the blood for excretion as urine. End-stage kidney failure usually progresses from chronic kidney failure. If prompt action is not taken to replace the function of the failed kidneys with dialysis or a kidney transplant, the condition is fatal.
What are the symptoms?
The main symptoms of end-stage kidney failure include:
Swelling of the face, the limbs, and to abdomen.
Headache and vomiting.
Very itchy skin.
Many people who have end-stage kidney failure also have breath that smells like ammonia, an odour similar to that of household bleach.
How is it diagnosed?
If your doctor suspects end-stage kidney failure, he or she will first arrange for urine tests and blood tests to detect abnormal levels of waste products. If the cause of kidney failure has not already been identified, you may also have to undergo imaging procedures such as ultrasound scanning, CT scanning, or radionuclide scanning to detect abnormalities in your kidneys.
What is the treatment?
Kidney dialysis, the usual treatment for end-stage kidney failure, takes over the function of filtering harmful waste products and excess water from the blood. However, long-term dialysis may lead to complications such as gradual weakening of the bones (see Osteoporosis), hyperparathyroidism, and anaemia, in which the oxygen-carrying capacity of the blood is reduced. The anaemia may develop due to a lack of the hormone erythropoietin, which is made in the kidneys and stimulates red blood cell production; it may be treated by injections of erythropoietin.
A kidney transplant offers the best hope of returning to a normal lifestyle. The main drawback of a transplant is that you will need to take immunosuppressants for the rest of your life to prevent your immune system from rejecting the donor organ. Occasionally, a second transplant is needed if the first kidney stops functioning. If you do not have a kidney transplant, you will need dialysis for the rest of your life.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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