About the Kidneys End Stage Renal Disease (ESRD)

Each year more than 50,000 people in the United States are diagnosed with end-stage renal disease (ESRD).

End-stage renal disease occurs when approximately 90% of normal kidney function has been lost. Symptoms include nausea, vomiting, weakness, fatigue and sluggishness, confusion and difficulty concentrating, decreased urine output, anemia, and loss of appetite. It can cause complications such as high blood pressure and congestive heart failure (a buildup of fluid in the heart).

ESRD Treatments

There are two accepted treatments for ESRD:

1. Dialysis, which substitutes for the kidneys in filtering body waste, and
2. Transplantation, in which a failed kidney is replaced with a healthy donor kidney. For eligible patients, kidney transplantation offers freedom from dependence on dialysis machines, and breakthroughs in surgical techniques and immunosuppresion therapy afford this opportunity to more people than ever before. Kidney transplant recipients today can expect to lead normal, productive lives for decades. Also, kidney transplantation has been show to result in a longer life expectancy than dialysis.

Diseases of the Kidneys

The most common causes of kidney failure that necessitate kidney transplantation include:

• Diabetes, whether Type 1 (juvenile) or Type 2 (adult-onset), is the leading cause of kidney failure in the U.S. Diabetes may cause many other diseases and complications, and should be monitored carefully.
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• High Blood Pressure and other vascular diseases.
• Autoimmune diseases such as chronic glomerulonephritis and lupus, which cause chronic inflammation of the kidneys.
• Congenital disorders such as obstructive uropathy (blockages in the urinary tract), which can cause irreversible kidney failure.

Other conditions resulting in end-stage renal disease may be
indications for renal transplantation:

• Pyelonephritis
• Polycystic kidney disease
• Congenital urinary tract defects
• Alport's disease
• Hypertensive nephrosclerosis
• Reflux neuropathy
• Interstitial nephritis
• IgA nephropathy
• Goodpasture's syndrome
• Hemolytic uremic syndrome
• Chemical nephrotoxicity
• Renal artery emboli
• Sickle cell nephropathy

Contraindications for Renal Tranplantation

Absolute contraindications for adults and children include (but may not be limited to):

• Advanced cardiopulmonary disease
• Active malignancy with the exception of skin cancer
• Severe local or systemic infection