Kidneys function to maintain the balance in acid and base balance of the blood, concentrate urine, control fluid and electrolyte levels--as well as get rid of waste products from the body. End-stage renal failure, also called ESRD, indicates complete or near complete failure of kidneys to perform any of these functions. According to Medline Plus, chronic renal failure characterized by a slow, progressive and irreversible loss of kidney function leads to ESRD when only 10 percent of the kidney's functioning ability remains. High blood pressure and diabetes are the most common causes of ESRD, Medline Plus says.
Dialysis
When kidney disease has progressed to the end stage, there are few treatment options left. One of those is hemodialysis, also called dialysis--a process of cleansing the blood of accumulated waste products, removing excess body fluids and maintaining the normal buffer and electrolyte levels. Before treatment, a permanent access site to the bloodstream must be surgically created, called a vascular access. During dialysis, this site is accessed by two needles connected to a machine called the dialyzer that filters waste products and returns the cleansed blood to the body. According to the Mayo Clinic, another type of dialysis treatment is peritoneal dialysis, in which the peritoneal cavity of the abdomen acts as the dialyzing filter.
Kidney Transplantation
Although dialysis treatment can sustain life, people with ESRD must get this treatment for the rest of their lives unless they opt for a kidney transplant. The Mayo Clinic says that in the absence of other life-threatening medical conditions, a kidney transplant can provide a better quality of life than dialysis in the long run. Kidney donors may be living or deceased with no difference to familial relation. However, a living, related donor closely matching the recipient is the most desirable source. A transplant center assists in searching for a donor, screening for blood and tissue matching as well as completely assisting the recipient through the donation and transplantation process. During the procedure, an incision is made in the lower abdomen--where the donor kidney is inserted and attached to the blood vessels--and the bladder, where the recipient's kidney used to be attached. Significant complications of transplant surgery include bleeding, infection, donor kidney rejection or failure.
Drug Treatment
Though dialysis or kidney transplant are the only treatments for ESRD, adjunct drug treatment with both procedures is necessary to maintain health. According to Medline Plus, people with ESRD are usually on a high blood pressure medication regimen. These include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers and other classes of drugs. Anemia, a side effect of dialysis, may be treated with iron supplements or a medicine that stimulates the production of red blood cells called erythropoietin. Moreover, following a kidney transplant, recipients must take drugs to suppress their immune system in order to prevent rejection of the donated kidney for the rest of their lives. According to Medline Plus, other treatments include specific dietary restrictions such as limiting proteins, fluids and electrolytes including sodium, potassium and others.
