Materiały źródłowe

• #1 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  More than 500,000 people in the United States live with end-stage renal disease (ESRD). The development of chronic kidney disease (CKD) and its progression to this terminal disease remains a significant source of reduced quality of life and premature mortality. […] This activity explains when this condition should be considered in the differential diagnosis and how to evaluate this condition properly. Furthermore, it highlights the interprofessional team’s role in caring for patients with this condition. […] Chronic kidney disease (CKD) is a debilitating disease, and standards of medical care involve aggressive monitoring for signs of disease progression and early referral to specialists for dialysis or possible renal transplant. […] End-stage renal disease is defined as a GFR of less than 15 mL/min.

• #2 Kidney failure (ESRD) – Symptoms, stages, & treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/kidney-failure

  Kidney failure means your kidneys are no longer able to work well enough to keep you alive. With kidney failure, 85-90% of your kidney function is gone. People with kidney failure have stage 5 CKD (also known as end-stage kidney disease or ESKD). […] People with kidney failure will need dialysis or a kidney transplant to survive. […] Urine and blood tests can check for signs of CKD. Estimated glomerular filtration rate (eGFR) is a blood test that checks how well the kidneys are filtering. […] People with kidney failure have an eGFR of less than 15 for 3 months or more (confirmed with repeat testing to make sure you dont have acute kidney injury) or they are on dialysis. […] Dialysis and kidney transplant are the two treatments for people with kidney failure. Dialysis treatments or a transplanted kidney will take over some of the work from your damaged kidneys and remove wastes and extra fluid from your body. […] There is no cure for kidney failure, but with treatment it is possible to live a longer and productive life.

• #3 End-stage renal disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538

  During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound. […] To diagnose end-stage renal disease, your health care provider may ask you about your family’s and your medical history. You may also have physical and neurological exams, along with other tests such as: […] Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood […] Urine tests, to check the level of the protein albumin in your urine […] Imaging tests, such as ultrasound, MRI or CT scan, to assess your kidneys and look for unusual areas […] Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.

• #4 End Stage Renal Disease (ESRD): Symptoms and More

  https://www.healthline.com/health/end-stage-kidney-disease

  End-stage kidney disease is also called end-stage renal disease (ESRD). The kidneys of people with ESRD function below 15% of their normal ability, which may mean theyre barely functioning or not functioning at all. […] Your doctor diagnoses ESRD using a physical examination and tests to check your kidney function. Kidney function tests include: Urinalysis: This test helps your doctor check for protein and blood in your urine. These substances indicate that your kidneys arent processing waste properly. Serum creatinine test: This test helps your doctor check whether creatinine is building up in your blood. Creatinine is a waste product that your kidneys should filter out of your body. Blood urea nitrogen test: This test helps your doctor check how much nitrogen is in your blood. Estimated glomerular filtration rate (GFR): This test allows your doctor to estimate how well your kidneys filter waste.

• #5 Laboratory Testing for Chronic Kidney Disease Diagnosis and Management | Test Guide | Quest Diagnostics Laboratory Testing for Chronic Kidney Disease Diagnosis and ManagementLaboratory Testing for Chronic Kidney Disease Diagnosis and Management

  https://testdirectory.questdiagnostics.com/test/test-guides/TG_CKD/laboratory-testing-for-chronic-kidney-disease-diagnosis-and-management

  Given that direct measurement of GFR may be problematic, eGFR, using either creatinine- or cystatin C–based measurements, is most commonly used to diagnose CKD in clinical practice. […] Creatinine-based eGFR is recommended by the Kidney Disease Improving Global Outcomes (KDIGO) 2012 international guideline for initial assessment of GFR.1 […] Cystatin C–based eGFR provides an alternative when creatinine-based estimates are not appropriate. […] A large meta-analysis has shown cystatin C–based eGFR improves risk classification for adverse outcomes (death, cardiovascular disease-related death, and end-stage renal disease) across diverse populations.6 […] A GFR <60 mL/min/1.73 m2 for >3 months and/or urine albumin-creatinine ratio ≥30 mg/g for >3 months define CKD.1 Combined, these test results provide a “Kidney Profile” recommended by the National Kidney Foundation for diagnosing and managing CKD in at-risk patients (Figure 1).1,10-12 The results are important independent risk predictors of major adverse cardiovascular events (myocardial infarction or stroke).13

• #6 Chronic Kidney Disease Tests & Diagnosis – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis

  Early kidney disease usually doesnt have any symptoms. Testing is the only way to know how well your kidneys are working. […] To check for kidney disease, health care providers use a blood test that checks how well your kidneys are filtering your blood, called GFR. GFR stands for glomerular filtration rate. […] If you have kidney disease, your health care provider will use the same two tests to help monitor your kidney disease and make sure your treatment plan is working. […] Your health care provider will use a blood test to check your kidney function. The results of the test mean the following: a GFR of less than 60 may mean you have kidney disease. […] A healthy kidney doesnt let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. […] If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. […] If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you.

• #7 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  More than 500,000 people in the United States live with end-stage renal disease (ESRD). The development of chronic kidney disease (CKD) and its progression to this terminal disease remains a significant source of reduced quality of life and premature mortality. […] This activity explains when this condition should be considered in the differential diagnosis and how to evaluate this condition properly. Furthermore, it highlights the interprofessional team’s role in caring for patients with this condition. […] Chronic kidney disease (CKD) is a debilitating disease, and standards of medical care involve aggressive monitoring for signs of disease progression and early referral to specialists for dialysis or possible renal transplant. […] End-stage renal disease is defined as a GFR of less than 15 mL/min.

• #8 2025 ICD-10-CM Diagnosis Code N18.6: End stage renal disease

  https://www.icd10data.com/ICD10CM/Codes/N00-N99/N17-N19/N18-/N18.6

  N18.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] The 2025 edition of ICD-10-CM N18.6 became effective on October 1, 2024. […] Chronic, irreversible renal failure. […] Long-standing and persistent renal disease with glomerular filtration rate (gfr) less than 15 ml/min. […] End stage renal disease due to hypertension. […] End stage renal disease on dialysis. […] End stage renal disease on peritoneal dialysis. […] End stage renal disease on dialysis due to type 2 diabetes mellitus. […] End stage renal disease on dialysis due to hypertension.

• #9 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  Many chronic diseases can cause end-stage renal disease. In many developed and developing countries, diabetes mellitus is the leading cause. […] According to the United States Renal Data System, in 2015, there were 124,411 new ESRD diagnoses, reflecting an increasing burden of kidney failure. […] Chronic kidney disease is diagnosed when there is evidence of kidney damage for at least three months or in any patient with a GFR of less than 60 mL/min for that same amount of time. […] To calculate GFR, three equations are commonly used (the MDRD [Modification of Diet in Renal Disease Study], CKD-EPI, and Cockcroft-Gault formula). […] Treatment of end-stage renal disease involves correcting parameters at the level of the patient’s presentation. […] For uremic manifestations, long-term renal replacement therapy (hemodialysis, peritoneal dialysis, or kidney transplantation) is needed.

• #10 End-stage renal disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538

  During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound. […] To diagnose end-stage renal disease, your health care provider may ask you about your family’s and your medical history. You may also have physical and neurological exams, along with other tests such as: […] Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood […] Urine tests, to check the level of the protein albumin in your urine […] Imaging tests, such as ultrasound, MRI or CT scan, to assess your kidneys and look for unusual areas […] Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.

• #11 Chronic kidney disease (CKD) – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd

  Checking for CKD is easy with two simple tests: a blood test known as the estimated glomerular filtration rate (eGFR) […] a urine test known as the urine albumin-creatinine ratio (uACR). Both tests are needed to have a clear picture of your kidney health. Having an eGFR under 60 and/or a uACR over 30 for three months or more is a sign you may have kidney disease. The eGFR is an estimate of how well your kidneys are removing waste products from the blood. It is calculated using your serum creatinine level, age, and sex. It can also be calculated using your cystatin C level. A normal eGFR varies according to age it decreases as you get older. For this test, a higher number is better. Your eGFR number is used to determine your stage of CKD. The uACR measures the amount of two different substances in your urine albumin (protein) and creatinine. Healthy kidneys keep the albumin in your blood while filtering the creatinine out into the urine. So, there should be very little or no albumin in your urine. The uACR is calculated by dividing the amount of urine albumin by the amount of urine creatinine to find the ratio. For this test, a lower number is better. Your uACR number is used to test for albuminuria – a significant risk factor for complications. In some cases, your healthcare professional may order additional tests to get more information about your kidney health. Some examples include a kidney biopsy or medical imaging (CT scan, ultrasound, or MRI).

• #12 End-stage renal disease (ESRD) Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/end-stage-renal-disease-esrd

  Urine tests: Urine analysis and urinary electrolytes. Your doctor may ask you to collect urine for 24 hours to look for decreased urine volume for Urine output assessment. […] Imaging: Your clinician may be using imaging studies such as ultrasound of your kidneys and computed tomography (CTscan) to get a detailed picture of your kidneys. […] Biopsy: A piece of kidney tissue is removed for testing. Your doctor may suggest a renal biopsy to extract a sample of kidney tissue for examination in some cases to detect the cause of ESRD.

• #13 Tests for kidney disease

  https://www.kidneyfund.org/all-about-kidneys/tests-kidney-disease

  The urine albumin-to-creatinine ratio (UACR) is a test that measures the amount of albumin (a type of protein) in your urine compared to the level of creatinine. This ratio helps doctors determine how well your kidneys are functioning. A UACR test is often used to detect early-stage kidney damage, especially in people at higher risk, such as those with diabetes or high blood pressure. […] A kidney biopsy can help your doctor figure out what is causing your kidney problem, how severe it is, and the best treatment. This involves removing a small piece of your kidney tissue for examination under a microscope. […] Genetic testing may help your healthcare team to diagnose, monitor, and manage certain types of kidney diseases. This type of testing can be helpful if you have a family history of kidney disease or if you don’t know the cause of your kidney disease.

• #14 Chronic Kidney Disease Tests & Diagnosis – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis

  Early kidney disease usually doesnt have any symptoms. Testing is the only way to know how well your kidneys are working. […] To check for kidney disease, health care providers use a blood test that checks how well your kidneys are filtering your blood, called GFR. GFR stands for glomerular filtration rate. […] If you have kidney disease, your health care provider will use the same two tests to help monitor your kidney disease and make sure your treatment plan is working. […] Your health care provider will use a blood test to check your kidney function. The results of the test mean the following: a GFR of less than 60 may mean you have kidney disease. […] A healthy kidney doesnt let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. […] If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. […] If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you.

• #15 End-stage renal disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538

  During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound. […] To diagnose end-stage renal disease, your health care provider may ask you about your family’s and your medical history. You may also have physical and neurological exams, along with other tests such as: […] Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood […] Urine tests, to check the level of the protein albumin in your urine […] Imaging tests, such as ultrasound, MRI or CT scan, to assess your kidneys and look for unusual areas […] Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.

• #16 End-stage renal disease (ESRD) Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/end-stage-renal-disease-esrd

  Urine tests: Urine analysis and urinary electrolytes. Your doctor may ask you to collect urine for 24 hours to look for decreased urine volume for Urine output assessment. […] Imaging: Your clinician may be using imaging studies such as ultrasound of your kidneys and computed tomography (CTscan) to get a detailed picture of your kidneys. […] Biopsy: A piece of kidney tissue is removed for testing. Your doctor may suggest a renal biopsy to extract a sample of kidney tissue for examination in some cases to detect the cause of ESRD.

• #17 Diagnosing Kidney Disease | NYU Langone Health

  https://nyulangone.org/conditions/kidney-disease/diagnosis

  A urine sample may be tested to determine if blood and certain proteins, such as albumin, are present. These substances can leak into urine when the kidneys aren’t functioning properly. Levels of protein and white and red blood cells in the urine can help the doctor pinpoint the abnormality in the kidneys. […] An ultrasound uses sound waves to produce images of the kidneys and other parts of the urinary system. Your doctor may perform an ultrasound to determine the size of the kidneys. Smaller kidneys suggest that kidney disease is chronic.

• #18 End-stage renal disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538

  During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound. […] To diagnose end-stage renal disease, your health care provider may ask you about your family’s and your medical history. You may also have physical and neurological exams, along with other tests such as: […] Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood […] Urine tests, to check the level of the protein albumin in your urine […] Imaging tests, such as ultrasound, MRI or CT scan, to assess your kidneys and look for unusual areas […] Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.

• #19 Chronic kidney disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/diagnosis-treatment/drc-20354527

  As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you’ve been diagnosed with high blood pressure, if you’ve taken a medication that might affect kidney function, if you’ve noticed changes in your urinary habits and whether you have family members who have kidney disease. […] For kidney disease diagnosis, you might also need certain tests and procedures to determine how severe your kidney disease is (stage). Tests might include: Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood. […] Your doctor might recommend a kidney biopsy, which involves removing a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that’s inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what’s causing your kidney problem.

• #20 Tests for kidney disease

  https://www.kidneyfund.org/all-about-kidneys/tests-kidney-disease

  The urine albumin-to-creatinine ratio (UACR) is a test that measures the amount of albumin (a type of protein) in your urine compared to the level of creatinine. This ratio helps doctors determine how well your kidneys are functioning. A UACR test is often used to detect early-stage kidney damage, especially in people at higher risk, such as those with diabetes or high blood pressure. […] A kidney biopsy can help your doctor figure out what is causing your kidney problem, how severe it is, and the best treatment. This involves removing a small piece of your kidney tissue for examination under a microscope. […] Genetic testing may help your healthcare team to diagnose, monitor, and manage certain types of kidney diseases. This type of testing can be helpful if you have a family history of kidney disease or if you don’t know the cause of your kidney disease.

• #21

  https://www.nhs.uk/conditions/kidney-disease/diagnosis/

  Chronic kidney disease (CKD) can be diagnosed with blood and urine tests. […] The main test for kidney disease is a blood test. The test measures the levels of a waste product called creatinine in your blood. […] Healthy kidneys should be able to filter more than 90ml/min. You may have CKD if your rate is lower than this. […] A urine test is also done to check the levels of substances called albumin and creatinine in your urine known as the albumin:creatinine ratio, or ACR. […] Your test results can be used to determine how damaged your kidneys are, known as the stage of CKD. […] Your eGFR results is given as a stage from 1 of 5: stage 1 (G1) a normal eGFR above 90ml/min, but other tests have detected signs of kidney damage; stage 2 (G2) a slightly reduced eGFR of 60 to 89ml/min, with other signs of kidney damage; stage 3a (G3a) an eGFR of 45 to 59ml/min; stage 3b (G3b) an eGFR of 30 to 44ml/min; stage 4 (G4) an eGFR of 15 to 29ml/min; stage 5 (G5) an eGFR below 15ml/min, meaning the kidneys have lost almost all of their function. […] For both eGFR and ACR, a higher stage indicates more severe kidney disease.

• #22 CKD staging | UK Kidney Association

  https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide/ckd-staging

  A patient is said to have chronic kidney disease (CKD) if they have abnormalities of kidney function or structure present for more than 3 months. […] The definition of CKD includes all individuals with markers of kidney damage or those with an eGFR of less than 60 ml/min/1.73m on at least 2 occasions 90 days apart (with or without markers of kidney damage). […] CKD is classified based on the eGFR and the level of proteinuria and helps to risk stratify patients. […] It is important to note that patients with an eGFR of 60 ml/min/1.73m should not be classified as having CKD unless they have other markers of kidney disease. […] Patients with CKD can be classified depending on their level of kidney function, or eGFR, and the amount of protein present in the urine. This information forms the basis of CKD staging which is useful for planning follow up and management. The higher the stage (G1-G5) and the greater the amount of protein present in the urine (A1-A3) the more „severe” the CKD and the higher the risk that a patient may develop renal failure requiring dialysis in the future.

• #23 Chronic kidney disease (CKD) – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd

  Checking for CKD is easy with two simple tests: a blood test known as the estimated glomerular filtration rate (eGFR) […] a urine test known as the urine albumin-creatinine ratio (uACR). Both tests are needed to have a clear picture of your kidney health. Having an eGFR under 60 and/or a uACR over 30 for three months or more is a sign you may have kidney disease. The eGFR is an estimate of how well your kidneys are removing waste products from the blood. It is calculated using your serum creatinine level, age, and sex. It can also be calculated using your cystatin C level. A normal eGFR varies according to age it decreases as you get older. For this test, a higher number is better. Your eGFR number is used to determine your stage of CKD. The uACR measures the amount of two different substances in your urine albumin (protein) and creatinine. Healthy kidneys keep the albumin in your blood while filtering the creatinine out into the urine. So, there should be very little or no albumin in your urine. The uACR is calculated by dividing the amount of urine albumin by the amount of urine creatinine to find the ratio. For this test, a lower number is better. Your uACR number is used to test for albuminuria – a significant risk factor for complications. In some cases, your healthcare professional may order additional tests to get more information about your kidney health. Some examples include a kidney biopsy or medical imaging (CT scan, ultrasound, or MRI).

• #24 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  End-stage renal disease (ESRD) is diagnosed when kidney function is no longer adequate for long-term survival without kidney transplantation or dialysis. […] Primary care clinicians should refer people at risk of ESRD to nephrology to optimize disease management. […] The decision to initiate dialysis is best made through shared decision-making. […] A palliative approach to ESRD is a reasonable alternative to dialysis, particularly for individuals with limited life expectancy, with severe comorbid conditions, or who wish to avoid medical interventions. […] For patients with ESRD, vaccination against seasonal influenza, tetanus, hepatitis B, human papillomavirus (through 26 years of age), and Streptococcus pneumoniae is advised. […] Routine cancer screening for patients not receiving kidney transplantation is discouraged.

• #25 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  More than 500,000 people in the United States live with end-stage renal disease (ESRD). The development of chronic kidney disease (CKD) and its progression to this terminal disease remains a significant source of reduced quality of life and premature mortality. […] This activity explains when this condition should be considered in the differential diagnosis and how to evaluate this condition properly. Furthermore, it highlights the interprofessional team’s role in caring for patients with this condition. […] Chronic kidney disease (CKD) is a debilitating disease, and standards of medical care involve aggressive monitoring for signs of disease progression and early referral to specialists for dialysis or possible renal transplant. […] End-stage renal disease is defined as a GFR of less than 15 mL/min.

• #26 Kidney failure – Wikipedia

  https://en.wikipedia.org/wiki/Kidney_failure

  Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. […] Diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine. […] Diagnosis of chronic failure is based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. […] Chronic kidney failure is measured in five stages, which are calculated using the person’s GFR, or glomerular filtration rate. Stage 5 CKD is considered a severe illness and requires some form of renal replacement therapy (dialysis) or kidney transplant whenever feasible.

• #27 Chronic kidney disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/diagnosis-treatment/drc-20354527

  As a first step toward diagnosis of kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor might ask questions about whether you’ve been diagnosed with high blood pressure, if you’ve taken a medication that might affect kidney function, if you’ve noticed changes in your urinary habits and whether you have family members who have kidney disease. […] For kidney disease diagnosis, you might also need certain tests and procedures to determine how severe your kidney disease is (stage). Tests might include: Blood tests. Kidney function tests look for the level of waste products, such as creatinine and urea, in your blood. […] Your doctor might recommend a kidney biopsy, which involves removing a sample of kidney tissue. Kidney biopsy is often done with local anesthesia using a long, thin needle that’s inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what’s causing your kidney problem.

• #28 End Stage Renal Disease (ESRD): Symptoms and More

  https://www.healthline.com/health/end-stage-kidney-disease

  End-stage kidney disease is also called end-stage renal disease (ESRD). The kidneys of people with ESRD function below 15% of their normal ability, which may mean theyre barely functioning or not functioning at all. […] Your doctor diagnoses ESRD using a physical examination and tests to check your kidney function. Kidney function tests include: Urinalysis: This test helps your doctor check for protein and blood in your urine. These substances indicate that your kidneys arent processing waste properly. Serum creatinine test: This test helps your doctor check whether creatinine is building up in your blood. Creatinine is a waste product that your kidneys should filter out of your body. Blood urea nitrogen test: This test helps your doctor check how much nitrogen is in your blood. Estimated glomerular filtration rate (GFR): This test allows your doctor to estimate how well your kidneys filter waste.

• #29 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  Patients with ESRD can elect a palliative approach to managing their disease that does not involve dialysis. […] Given the limited life expectancy for most patients with ESRD who do not undergo kidney transplantation, routine cancer screening is discouraged in these patients. […] People with ESRD are at high risk of developing protein-energy wasting and other malnutrition disorders and should receive nutritional counseling from a registered dietitian. […] Most patients receiving dialysis have hypertension. […] Blood pressure control is closely associated with volume status, modifying dialysis sessions to maintain normovolemia can improve blood pressure control. […] Clinicians caring for patients with ESRD should be aware of its many complications.

• #30 End-Stage Renal Disease (ESRD): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/end-stage-renal-disease-nursing-diagnosis-care-plan/

  The estimated glomerular filtration rate (eGFR) gauges the kidneys capacity to filter waste products and classifies chronic kidney disease into five stages. An eGFR below 15 ml/min is stage 5 CKD, also known as ESRD. The kidneys will no longer function at all. […] The first step of nursing care is the nursing assessment, during which the nurse will gather physical, psychosocial, emotional, and diagnostic data. […] Complications that occur due to kidney damage include: Volume overload resistant to diuretics, Poorly controlled hypertension, Anemia, Electrolyte abnormalities, Bone deficiencies, Metabolic abnormalities, Decreased immune response. […] The kidneys process and filter both prescription and over-the-counter drugs. The following medications can further damage the kidneys: Cholesterol medications, Pain medications (NSAIDs), Antibiotics, Antiretrovirals, Antidiabetic medications.

• #31 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Shared decision-making should be used, with adequate time for patients to consider the various dialysis modalities and the option of conservative management. […] Alone, GFR does not determine when dialysis is initiated; instead, guidelines advise starting dialysis when irreversible signs or symptoms of ESRD manifest. […] Most patients with ESRD will be treated with hemodialysis, and arteriovenous access (fistula or graft) is usually preferred.

• #32

  https://link.springer.com/article/10.1134/S0006297923100164

  Chronic kidney disease can progress to the end-stage renal disease (ESRD) characterized by a high risk of morbidity and mortality. […] ESRD requires immediate therapy or even dialysis or kidney transplantation, therefore, its timely diagnostics is critical for many patients. […] At present, assessment of CKD stage and diagnostics of ESRD are based on morphological and functional symptoms of kidney damage. […] Therefore, there is still a need for biomarkers that can be employed for the diagnostics of CKD and, especially, ESRD. […] Renal fibrosis is a typical outcome of inflammation that occurs in almost all nephropathies. […] Therefore, markers of kidney fibrosis can also be used as universal markers in the diagnostics of CKD and ESRD. […] In this review, we summarize information on currently known biomarkers of inflammation, kidney fibrosis, hormonal changes, and epigenetic changes and discusses their application in the diagnostics of CKD-to-ESRD progression.

• #33

  https://link.springer.com/article/10.1134/S0006297923100164

  The most common cause of CKD and ESRD is diabetes mellitus. […] One of the most important factors in the development of renal pathology is inflammation. […] ESRD can also accompany glomerulosclerosis, tubulointerstitial fibrosis, and atrophy. […] Finally, ESRD is associated with endocrine disorders and epigenetic changes. […] The following biomarkers of systemic inflammatory response identified in blood were found to be closely associated with CKD progression: proinflammatory cytokines: TNF-, IL-6, and IL-18; […] Unfortunately, there is a limited information on the relationship between inflammatory markers, GFR levels, and ESRD development at different CKD stages, including patients on dialysis. […] Thus, the use of urinary MMP-7 content together with other parameters, such as eGFR, mean arterial blood pressure, proteinuria, and histological score, has significantly improved prediction of a 3-year risk of IgA nephropathy progression.

• #34

  https://link.springer.com/article/10.1134/S0006297923100164

  Hence, kidney fibrosis biomarkers can reflect the severity of CKD and its progression to ESRD, as well as to predict kidney transplant rejection and even mortality. […] It was suggested that epigenetic markers could predict the severity of CKD, distinguish between different CKD stages, and evaluate the risk of ESRD. […] The most promising epigenetic markers of renal fibrosis are microRNAs (miRs) and DNA methylation; they are commonly analyzed in blood cells or urine and used as prognostic factors of CKD and ESRD development. […] Integration of the above biomarkers into everyday diagnostics will allow to attain personalized approach to patients in order to better predict the disease outcome and to select the treatment. […] Here, we reported putative inflammatory, fibrosis, hormonal, and epigenetic markers indicative of severe deterioration of renal function and ESRD progression.

• #35

  https://link.springer.com/article/10.1134/S0006297923100164

  Hence, kidney fibrosis biomarkers can reflect the severity of CKD and its progression to ESRD, as well as to predict kidney transplant rejection and even mortality. […] It was suggested that epigenetic markers could predict the severity of CKD, distinguish between different CKD stages, and evaluate the risk of ESRD. […] The most promising epigenetic markers of renal fibrosis are microRNAs (miRs) and DNA methylation; they are commonly analyzed in blood cells or urine and used as prognostic factors of CKD and ESRD development. […] Integration of the above biomarkers into everyday diagnostics will allow to attain personalized approach to patients in order to better predict the disease outcome and to select the treatment. […] Here, we reported putative inflammatory, fibrosis, hormonal, and epigenetic markers indicative of severe deterioration of renal function and ESRD progression.

• #36

  https://link.springer.com/article/10.1134/S0006297923100164

  Hence, kidney fibrosis biomarkers can reflect the severity of CKD and its progression to ESRD, as well as to predict kidney transplant rejection and even mortality. […] It was suggested that epigenetic markers could predict the severity of CKD, distinguish between different CKD stages, and evaluate the risk of ESRD. […] The most promising epigenetic markers of renal fibrosis are microRNAs (miRs) and DNA methylation; they are commonly analyzed in blood cells or urine and used as prognostic factors of CKD and ESRD development. […] Integration of the above biomarkers into everyday diagnostics will allow to attain personalized approach to patients in order to better predict the disease outcome and to select the treatment. […] Here, we reported putative inflammatory, fibrosis, hormonal, and epigenetic markers indicative of severe deterioration of renal function and ESRD progression.

• #37 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  Controlling blood pressure in patients receiving dialysis improves mortality. […] Insulin is the preferred treatment for patients with ESRD and diabetes mellitus requiring medication. […] Patients should be monitored for signs of protein-energy wasting and malnutrition. […] Clinicians must be aware of the many medical complications associated with ESRD. […] Early nephrology referral for patients at increased risk of ESRD is vital because it is associated with improved patient-centered outcomes, including mortality. […] Patients with chronic kidney disease should be referred to nephrology if their estimated GFR falls below 30 mL per minute per 1.73 m2. […] Goals of early referral include initiating disease-specific therapies; slowing the progression of chronic kidney disease; evaluating and treating comorbid conditions and complications; providing psychosocial support; and planning for kidney transplantation, dialysis, or conservative kidney management.

• #38 Who Gets End Stage Renal Disease (ESRD)? – DaVita

  https://www.davita.com/education/kidney-disease/symptoms/who-gets-end-stage-renal-disease

  Without proper treatment, ESRD can develop much sooner than expected, and you will need to undergo dialysis or a kidney transplant. […] The only treatment available to those who do develop ESRD is dialysis or a kidney transplant. These are the treatments that can keep you alive. Without them, you will continue to accumulate toxins and excess fluid in your bloodstream causing your major organs to shut down, which can lead to death. […] With the early detection of the underlying causes of ESRD, your healthcare team may help you slow the progression of ESRD. You can take an active role. By being aware of your familys medical history, going in for regular check ups, taking medication prescribed for your high blood pressure or diabetes and following your doctors advice, you may prolong the life of your kidneys and delay the need for dialysis or a kidney transplant.

• #39 Who Gets End Stage Renal Disease (ESRD)? – DaVita

  https://www.davita.com/education/kidney-disease/symptoms/who-gets-end-stage-renal-disease

  Without proper treatment, ESRD can develop much sooner than expected, and you will need to undergo dialysis or a kidney transplant. […] The only treatment available to those who do develop ESRD is dialysis or a kidney transplant. These are the treatments that can keep you alive. Without them, you will continue to accumulate toxins and excess fluid in your bloodstream causing your major organs to shut down, which can lead to death. […] With the early detection of the underlying causes of ESRD, your healthcare team may help you slow the progression of ESRD. You can take an active role. By being aware of your familys medical history, going in for regular check ups, taking medication prescribed for your high blood pressure or diabetes and following your doctors advice, you may prolong the life of your kidneys and delay the need for dialysis or a kidney transplant.

• #40 Tests for kidney disease

  https://www.kidneyfund.org/all-about-kidneys/tests-kidney-disease

  Many people with kidney disease don’t know they have it until their kidneys are already damaged because they don’t have any symptoms. This makes early testing important, especially if you’re at increased risk due to factors like diabetes, high blood pressure, or a family history of kidney disease. Early detection and treatment can slow or even stop kidney disease from getting worse. […] Learning about the tests, what they do, and what to expect can help you and your doctor catch kidney disease early when it is most treatable. Doctors can help find the cause of kidney disease through these tests, make a personalized treatment plan, and help you improve your quality of life. […] Your healthcare provider may use a blood test for cystatin C to calculate your eGFR. A cystatin C test may provide a more accurate estimate of kidney function, especially if there is concern about the reliability of creatinine-based results.

• #41 Chronic Kidney Disease: Detection and Evaluation | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1215/p776.html

  Because CKD can progress to advanced renal failure, end-stage renal disease, and even death, early detection is critical for initiating timely therapeutic interventions, limiting nephrotoxin exposure, preventing further reduction in GFR, and preparing for renal replacement therapy. […] The U.S. Preventive Services Task Force concluded that the evidence is insufficient to assess the balance of benefits and harms of routine screening for CKD in asymptomatic adults. […] Screening for CKD includes measurement of serum creatinine, estimation of GFR using a serum creatinine-based equation, measurement of the urine albumin/creatinine ratio, and urinalysis. […] Serum cystatin C is a filtration marker that has emerged as an alternative to serum creatinine to more accurately estimate GFR and classify CKD.

• #42 Diagnosis of Kidney Disease – Dialysis Patient Citizens Education Center

  https://www.dpcedcenter.org/what-is-kidney-disease/diagnosis-of-kidney-disease/

  A few simple tests can alert you and your doctor to early kidney disease for additional testing or diagnose you with the disease. […] Even if you only have one of the risk factors, it is a good idea to get a screening at one of the free testing sites or at your doctors office. There will be minor differences from place to place, but the basic tests used are blood, urine, imaging or biopsy. […] A more direct test is to measure your creatinine levels to get an idea of how well your kidneys are working. Creatinine levels combined with age, gender and race combine to give an estimated glomerular filtration rate (eGFR). This number is used to determine the extent of damage to your kidneys. […] High blood pressure is one of the leading causes of kidney failure and an abnormally high result will alert your doctor to do more tests. […] The ultrasound will enable your doctor to view the soft tissue to get an idea of the size and function of your kidneys. […] This is a simple test that can be done quickly to determine if there are abnormalities such as excess protein in your urine.

• #43 Why Is Chronic Kidney Disease (CKD) on the Rise? 6 Things to Know > News > Yale Medicine

  https://www.yalemedicine.org/news/why-is-chronic-kidney-disease-ckd-on-the-rise

  Good preventive health care could be key to an early diagnosis. […] When people finally start to experience symptoms, such as itchy skin, an impaired ability to urinate, and unexplained weight loss, among others, it means the disease has reached an irreversible stage. At that point, they may have lost so much kidney function that they will need dialysis or a kidney transplant. […] However, diagnosing and treating CKD early may help stop it from advancing. […] CKD can be detected (and monitored) using two simple tests: a blood test and a urine test. […] The first is often done as part of a regular physical examination with routine bloodwork that includes a test called glomerular filtration rate (GFR)the GFR score is based on the level of creatinine in a persons blood, combined with their age and sex.

• #44 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  Controlling blood pressure in patients receiving dialysis improves mortality. […] Insulin is the preferred treatment for patients with ESRD and diabetes mellitus requiring medication. […] Patients should be monitored for signs of protein-energy wasting and malnutrition. […] Clinicians must be aware of the many medical complications associated with ESRD. […] Early nephrology referral for patients at increased risk of ESRD is vital because it is associated with improved patient-centered outcomes, including mortality. […] Patients with chronic kidney disease should be referred to nephrology if their estimated GFR falls below 30 mL per minute per 1.73 m2. […] Goals of early referral include initiating disease-specific therapies; slowing the progression of chronic kidney disease; evaluating and treating comorbid conditions and complications; providing psychosocial support; and planning for kidney transplantation, dialysis, or conservative kidney management.

• #45 Chronic Kidney Disease: Detection and Evaluation | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1215/p776.html

  Serum cystatin C and serum creatinine levels can be obtained concurrently for recalculation of the estimated GFR using the appropriate calculator. […] Severe albuminuria independently predicts mortality and end-stage renal disease. […] Nephrology consultation is indicated when the estimated GFR is less than 30 mL per minute per 1.73 m2, or earlier if necessary.

• #46 CKD staging | UK Kidney Association

  https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide/ckd-staging

  These patients should have a management plan that has been advised by a kidney specialist, either with an agreed management plan and a defined threshold for re-referral or under follow-up in a kidney clinic. […] End-stage renal failure refers to patients who have insufficient kidney function to keep them feeling well and who may benefit from treatments which take on some of the functions of the kidney, such as dialysis or a transplant.

• #47 CKD staging | UK Kidney Association

  https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide/ckd-staging

  The Kidney Failure Risk Equation (KFRE) is a well-validated risk prediction tool for a kidney replacement therapy (KRT) in the next two or five years in individuals with chronic kidney disease (CKD) stages 3a-5. […] The KFRE should be calculated when an individual with CKD Stage 3a-5 has an eGFR and ACR measured. […] The 4 variable Kidney Failure Risk Equation (KFRE) should be used to calculate patient risk of progression to renal failure using age, sex, eGFR and urine ACR values every time renal function monitoring is undertaken. A 5-year risk of kidney failure 5% should prompt referral to a nephrology specialist. […] Patients with CKD stage G3 have impaired kidney function. Only a minority of patients with CKD stage G3 go on to develop more serious kidney disease. […] Patients with an eGFR of 15 ml/min/1.73m, or who require some form of dialysis, have CKD stage G5 which is often referred to as End-Stage Renal Failure (ESRF). This CKD stage represents patients with the lowest level of kidney function.

• #48 Chronic Kidney Disease – Identification, Evaluation and Management of Adult Patients – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/chronic-kidney-disease

  CKD cannot be diagnosed with one isolated abnormal measurement of eGFR or urine ACR. […] Values of 60 mL/min per 1.73m2 without other markers of kidney disease (albuminuria, hematuria, structural abnormalities) do not indicate CKD. […] Values of 60 mL/min per 1.73m2 which are persistent (present for 3 months) are diagnostic of CKD. […] A single isolated measurement 60 mL/min does not satisfy diagnostic criteria for CKD, but could reflect reduced kidney function and requires confirmatory testing. […] In patients with a new unexpected finding of reduced eGFR, the test should be repeated to establish stability or rapid deterioration. […] Urine test abnormalities, even with persistent eGFR values 60 mL/min per 1.73m2 suggest kidney disease. […] Renal ultrasound should be undertaken to assess structural abnormalities and aid in diagnosis. […] Risk staging of kidney disease is important for care planning and patient management. Risk is determined based on Cause, eGFR, and uACR, or CGA. […] The Kidney Failure Risk Equation (KFRE) is an equation designed to estimate probability of requiring dialysis within 2 or 5 years.

• #49 CKD staging | UK Kidney Association

  https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide/ckd-staging

  The Kidney Failure Risk Equation (KFRE) is a well-validated risk prediction tool for a kidney replacement therapy (KRT) in the next two or five years in individuals with chronic kidney disease (CKD) stages 3a-5. […] The KFRE should be calculated when an individual with CKD Stage 3a-5 has an eGFR and ACR measured. […] The 4 variable Kidney Failure Risk Equation (KFRE) should be used to calculate patient risk of progression to renal failure using age, sex, eGFR and urine ACR values every time renal function monitoring is undertaken. A 5-year risk of kidney failure 5% should prompt referral to a nephrology specialist. […] Patients with CKD stage G3 have impaired kidney function. Only a minority of patients with CKD stage G3 go on to develop more serious kidney disease. […] Patients with an eGFR of 15 ml/min/1.73m, or who require some form of dialysis, have CKD stage G5 which is often referred to as End-Stage Renal Failure (ESRF). This CKD stage represents patients with the lowest level of kidney function.

• #50 Chronic kidney disease diagnosis using decision tree algorithms | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02474-z

  Chronic Kidney Disease (CKD), i.e., gradual decrease in the renal function spanning over a duration of several months to years without any major symptoms, is a life-threatening disease. […] CKD is often diagnosed in later stages when dialysis or kidney transplant are the only options left to save the patients life. Whereas an early diagnosis can lead to the prevention of kidney failure. […] The best way to measure the kidney function or to predict the stages of kidney disease is to monitor the Glomerular Filtration Rate (GFR) on regular basis. […] GFR is calculated using age, gender, race and blood creatinine value of a person. Based on the value of GFR, CKD may be categorized into six stages as shown in Table 1. […] Symptoms of CKD are not disease specific. The symptoms develop gradually, and some patients may not have any symptoms at all. Hence, it becomes very difficult to detect the disease at early stages.

• #51 Chronic kidney disease diagnosis using decision tree algorithms | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02474-z

  Machine Learning (ML) has recently played a significant role for the diagnosis of diseases by just analyzing the records of existing patients and training a model to predict the behavior of new patients. […] CKD has been recognized as a leading public health issue. Millions of people die each year due to inadequate provision of healthcare, lack of health education and high cost treatment of CKD. […] This study reveals the results in three phases, i.e., preprocessing, computation and final results to predict the stages of chronic kidney disease. […] GFR is defined as the amount of plasma that is filtered by glomeruli per unit of time and is calculated by estimating the rate of clearance of a substance from plasma. It is considered as one of the best attributes to measure the level of kidney function and to determine the severity of CKD.

• #52 Chronic kidney disease diagnosis using decision tree algorithms | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02474-z

  Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) is considered to be more precise for the estimation of the glomerular filtration rate (eGFR) than the modification of diet in renal disease (MDRD). […] In this study, we established and compared two algorithms including J48 and random forest to predict the various stages of CKD. It is observed that the ratio of correctly classified instances by J48 is 85.5%, whereas, it is 78.25% for Random Forest. […] Hence, it can be said that J48 is accurate and efficient in terms of execution time because its comparison with Random Forest shows that it provides results with better accuracy and less time.

• #53 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Shared decision-making should be used, with adequate time for patients to consider the various dialysis modalities and the option of conservative management. […] Alone, GFR does not determine when dialysis is initiated; instead, guidelines advise starting dialysis when irreversible signs or symptoms of ESRD manifest. […] Most patients with ESRD will be treated with hemodialysis, and arteriovenous access (fistula or graft) is usually preferred.

• #54 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Shared decision-making should be used, with adequate time for patients to consider the various dialysis modalities and the option of conservative management. […] Alone, GFR does not determine when dialysis is initiated; instead, guidelines advise starting dialysis when irreversible signs or symptoms of ESRD manifest. […] Most patients with ESRD will be treated with hemodialysis, and arteriovenous access (fistula or graft) is usually preferred.

• #55 Kidney Failure: Stages, ESRD, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17689-kidney-failure

  Kidney failure treatment depends on the cause and severity of the condition. Healthcare providers can’t cure kidney failure, and the disease is life-threatening. But treatment can help you live longer and manage any symptoms or complications. […] If you’re in end-stage kidney failure, you need treatment to keep you alive. There are two main treatments for kidney failure: dialysis and a kidney transplant. […] It depends. With proper treatment, you can continue to live a happy, fulfilling life. But, you can expect to need treatment for the rest of your life. Remember, you can’t reverse kidney disease or kidney failure, you can only slow its progression.

• #56 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Shared decision-making should be used, with adequate time for patients to consider the various dialysis modalities and the option of conservative management. […] Alone, GFR does not determine when dialysis is initiated; instead, guidelines advise starting dialysis when irreversible signs or symptoms of ESRD manifest. […] Most patients with ESRD will be treated with hemodialysis, and arteriovenous access (fistula or graft) is usually preferred.

• #57 Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/238798-overview

  Early diagnosis and treatment of the underlying cause and/or institution of secondary preventive measures is imperative in patients with CKD. These may slow, or possibly halt, progression of the disease. […] Indications for renal replacement therapy include the following: Severe metabolic acidosis, Hyperkalemia, Pericarditis, Encephalopathy, Intractable volume overload, Failure to thrive and malnutrition, Peripheral neuropathy, Intractable gastrointestinal symptoms, In asymptomatic patients, a GFR of 5-9 mL/min/1.73 m, irrespective of the cause of the CKD or the presence or absence of other comorbidities. […] Patients with chronic kidney disease (CKD) generally experience progressive loss of kidney function and are at risk for end-stage kidney disease (ESKD). The rate of progression depends on age, the underlying diagnosis, the implementation and success of secondary preventive measures, and the individual patient. Timely initiation of long-term renal replacement therapy is imperative to prevent the uremic complications of CKD that can lead to significant morbidity and death.

• #58 Chronic kidney disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/chronic-kidney-disease/

  End-stage renal disease (ESRD); [10] […] Irreversible kidney dysfunction with eGFR 2 […] AND manifestations of uremia requiring chronic renal replacement therapy with either dialysis (hemofiltration or hemodiafiltration) or renal transplantation […] Prognosis: approx. 50% of individuals with ESRD die of cardiovascular disease. […] […] […] The diagnosis of CKD requires the persistence of eGFR 2 and/or of a marker of kidney damage for more than 3 months. […] […] […] If any indications for acute dialysis are identified, proceed with urgent renal replacement therapy. […] […] […] Renal replacement therapy [5] […] Nonoperative (hemodialysis or peritoneal dialysis) […] Indications include: […] Hemodynamic or metabolic complications that are refractory to medical therapy, e.g.: […] Volume overload or hypertension […] Metabolic acidosis […] Hyperkalemia […] […] […] Operative: kidney transplantation

• #59 Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/238798-overview

  Early diagnosis and treatment of the underlying cause and/or institution of secondary preventive measures is imperative in patients with CKD. These may slow, or possibly halt, progression of the disease. […] Indications for renal replacement therapy include the following: Severe metabolic acidosis, Hyperkalemia, Pericarditis, Encephalopathy, Intractable volume overload, Failure to thrive and malnutrition, Peripheral neuropathy, Intractable gastrointestinal symptoms, In asymptomatic patients, a GFR of 5-9 mL/min/1.73 m, irrespective of the cause of the CKD or the presence or absence of other comorbidities. […] Patients with chronic kidney disease (CKD) generally experience progressive loss of kidney function and are at risk for end-stage kidney disease (ESKD). The rate of progression depends on age, the underlying diagnosis, the implementation and success of secondary preventive measures, and the individual patient. Timely initiation of long-term renal replacement therapy is imperative to prevent the uremic complications of CKD that can lead to significant morbidity and death.

• #60 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  A key consideration for patients with ESRD is establishing eligibility for kidney transplantation, which, compared with dialysis or conservative management, improves survival and quality of life. […] Most patients elect to receive dialysis to treat their ESRD, and these patients tend to live longer than those choosing conservative management. […] Shared decision-making should be used, with adequate time for patients to consider the various dialysis modalities and the option of conservative management. […] Alone, GFR does not determine when dialysis is initiated; instead, guidelines advise starting dialysis when irreversible signs or symptoms of ESRD manifest. […] Most patients with ESRD will be treated with hemodialysis, and arteriovenous access (fistula or graft) is usually preferred.

• #61 End Stage Renal Disease (ESRD): Symptoms and More

  https://www.healthline.com/health/end-stage-kidney-disease

  The treatments for ESRD are dialysis or a kidney transplant. In some cases, lifestyle changes and medications may help. […] Kidney transplant surgery involves removing your affected kidneys (if removal is needed) and placing a functioning donated organ. One healthy kidney is all you need, so donors are often living. They can donate one kidney and continue to function normally with the other. […] Treatment can help you live a long time with kidney disease. Maintaining a well-balanced diet, managing blood pressure and blood sugar levels, and maintaining weight are important. […] In some cases, ESRD isnt preventable. However, you should control your blood glucose levels and your blood pressure. You should always call a doctor if you have any ESRD symptoms. Early detection and treatment can delay or prevent the disease from progressing.

• #62 End stage renal disease (ESRD) – Kidney Care Center

  https://kidneycares.com/end-stage-renal-disease-esrd/

  A kidney transplant involves a surgical procedure where a healthy kidney is implanted from either a living or deceased donor into an individual whose own kidneys are no longer operating effectively. […] Dialysis serves to supplement the function of your kidneys when they are unable to perform their tasks adequately. […] If you opt not to undergo a kidney transplant or dialysis, palliative or supportive care is an alternative route to managing symptoms and enhancing your well-being. […] While healthcare providers cannot cure kidney failure, they can manage its life-threatening nature. Dialysis or a kidney transplant can extend your life span, address symptoms, and manage complications, enabling you to continue enjoying your preferred activities.

• #63 Why Is Chronic Kidney Disease (CKD) on the Rise? 6 Things to Know > News > Yale Medicine

  https://www.yalemedicine.org/news/why-is-chronic-kidney-disease-ckd-on-the-rise

  If, however, you progress to ESKD and your kidneys fail, you will need either dialysis or a kidney transplant to replace the work of the kidneys. […] Out of almost 808,000 people in the U.S. who have ESKD, 69% are on dialysis, which was once done only in a health care setting. […] Still, a kidney transplant is often the best solutionpreferably before a patient reaches the point of requiring dialysis, Dr. Luciano says. […] The hope is that some of the newer medications will allow patients to stay on the waiting list longer without needing dialysis, Dr. Luciano says.

• #64 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  End-stage renal disease (ESRD) is diagnosed when kidney function is no longer adequate for long-term survival without kidney transplantation or dialysis. […] Primary care clinicians should refer people at risk of ESRD to nephrology to optimize disease management. […] The decision to initiate dialysis is best made through shared decision-making. […] A palliative approach to ESRD is a reasonable alternative to dialysis, particularly for individuals with limited life expectancy, with severe comorbid conditions, or who wish to avoid medical interventions. […] For patients with ESRD, vaccination against seasonal influenza, tetanus, hepatitis B, human papillomavirus (through 26 years of age), and Streptococcus pneumoniae is advised. […] Routine cancer screening for patients not receiving kidney transplantation is discouraged.

• #65 End-Stage Renal Disease: Medical Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1100/p493.html

  Patients with ESRD can elect a palliative approach to managing their disease that does not involve dialysis. […] Given the limited life expectancy for most patients with ESRD who do not undergo kidney transplantation, routine cancer screening is discouraged in these patients. […] People with ESRD are at high risk of developing protein-energy wasting and other malnutrition disorders and should receive nutritional counseling from a registered dietitian. […] Most patients receiving dialysis have hypertension. […] Blood pressure control is closely associated with volume status, modifying dialysis sessions to maintain normovolemia can improve blood pressure control. […] Clinicians caring for patients with ESRD should be aware of its many complications.

• #66 End stage renal disease (ESRD) – Kidney Care Center

  https://kidneycares.com/end-stage-renal-disease-esrd/

  A kidney transplant involves a surgical procedure where a healthy kidney is implanted from either a living or deceased donor into an individual whose own kidneys are no longer operating effectively. […] Dialysis serves to supplement the function of your kidneys when they are unable to perform their tasks adequately. […] If you opt not to undergo a kidney transplant or dialysis, palliative or supportive care is an alternative route to managing symptoms and enhancing your well-being. […] While healthcare providers cannot cure kidney failure, they can manage its life-threatening nature. Dialysis or a kidney transplant can extend your life span, address symptoms, and manage complications, enabling you to continue enjoying your preferred activities.

• #67 Hospice For Kidney Failure: Helpful Eligibility Criteria You Need To Know

  https://www.threeoakshospice.com/hospice-for-renal-disease/

  In general, hospice patients are less likely to experience emergency hospitalization than kidney failure patients who don’t utilize hospice services. Chronic kidney disease patients who require significant end-of-life care can also cause their caregivers emotional and mental stress, and hospice helps relieve this burden. […] When a patient with end-stage kidney disease opts to enter hospice, this choice is intended to help improve quality of life and manage pain or other symptoms. […] The overall goal of symptom management is to optimize the patient’s comfort. […] Coordinated hospice care includes cooperation between family caregivers, the primary care physician, the hospice team and the patient. […] Hospice services are typically provided at the patient’s place of residence. […] Patients can access care 24 hours a day.

• #68 Hospice For Kidney Failure: Helpful Eligibility Criteria You Need To Know

  https://www.threeoakshospice.com/hospice-for-renal-disease/

  Patients diagnosed with end-stage renal disease, also known as end-stage kidney disease, require specialized care at the end of life. Hospice for renal disease helps patients maintain the best possible quality of life during those final days, weeks or months by providing symptom management, assistance with everyday tasks, emotional support and relief for primary caregivers. […] The goal is never to hasten death but to keep the patient comfortable and improve quality of life during the end stages of kidney disease. […] Patients with chronic kidney disease may be eligible for hospice services if they: […] Typically, hospice for renal disease is designed for patients with a life expectancy of 6 months or less. Patients entering hospice must not be pursuing curative treatment for the disease. This includes treatment options such as dialysis and kidney transplants.

• #69 Hospice For Kidney Failure: Helpful Eligibility Criteria You Need To Know

  https://www.threeoakshospice.com/hospice-for-renal-disease/

  Family members or friends who provide caregiving for a patient with end-stage kidney disease also benefit from hospice services. […] Caring for a patient with renal failure can be complicated, and Three Oaks Hospice helps caregivers understand the progression of end-stage kidney disease as well as giving information about best care practices for patients with decreased kidney function. […] Three Oaks Hospice offers a wide range of hospice services for patients with end-stage kidney disease and other terminal illnesses.

• #70 End-stage renal disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/diagnosis-treatment/drc-20354538

  During a kidney biopsy, your doctor uses a needle to remove a small sample of kidney tissue for lab testing. The biopsy needle is inserted through your skin and is often directed using the guidance of an imaging device, such as ultrasound. […] To diagnose end-stage renal disease, your health care provider may ask you about your family’s and your medical history. You may also have physical and neurological exams, along with other tests such as: […] Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood […] Urine tests, to check the level of the protein albumin in your urine […] Imaging tests, such as ultrasound, MRI or CT scan, to assess your kidneys and look for unusual areas […] Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.

• #71 Chronic Kidney Disease Tests & Diagnosis – NIDDK

  https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis

  Early kidney disease usually doesnt have any symptoms. Testing is the only way to know how well your kidneys are working. […] To check for kidney disease, health care providers use a blood test that checks how well your kidneys are filtering your blood, called GFR. GFR stands for glomerular filtration rate. […] If you have kidney disease, your health care provider will use the same two tests to help monitor your kidney disease and make sure your treatment plan is working. […] Your health care provider will use a blood test to check your kidney function. The results of the test mean the following: a GFR of less than 60 may mean you have kidney disease. […] A healthy kidney doesnt let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. […] If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. […] If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you.

• #72 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  More than 500,000 people in the United States live with end-stage renal disease (ESRD). The development of chronic kidney disease (CKD) and its progression to this terminal disease remains a significant source of reduced quality of life and premature mortality. […] This activity explains when this condition should be considered in the differential diagnosis and how to evaluate this condition properly. Furthermore, it highlights the interprofessional team’s role in caring for patients with this condition. […] Chronic kidney disease (CKD) is a debilitating disease, and standards of medical care involve aggressive monitoring for signs of disease progression and early referral to specialists for dialysis or possible renal transplant. […] End-stage renal disease is defined as a GFR of less than 15 mL/min.

• #73 Kidney failure – Wikipedia

  https://en.wikipedia.org/wiki/Kidney_failure

  Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. […] Diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine. […] Diagnosis of chronic failure is based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. […] Chronic kidney failure is measured in five stages, which are calculated using the person’s GFR, or glomerular filtration rate. Stage 5 CKD is considered a severe illness and requires some form of renal replacement therapy (dialysis) or kidney transplant whenever feasible.

• #74 Tests for kidney disease

  https://www.kidneyfund.org/all-about-kidneys/tests-kidney-disease

  Many people with kidney disease don’t know they have it until their kidneys are already damaged because they don’t have any symptoms. This makes early testing important, especially if you’re at increased risk due to factors like diabetes, high blood pressure, or a family history of kidney disease. Early detection and treatment can slow or even stop kidney disease from getting worse. […] Learning about the tests, what they do, and what to expect can help you and your doctor catch kidney disease early when it is most treatable. Doctors can help find the cause of kidney disease through these tests, make a personalized treatment plan, and help you improve your quality of life. […] Your healthcare provider may use a blood test for cystatin C to calculate your eGFR. A cystatin C test may provide a more accurate estimate of kidney function, especially if there is concern about the reliability of creatinine-based results.

• #75 Chronic kidney disease and the global public health agenda: an international consensus | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-024-00820-6

  Early detection is a key strategy to prevent kidney disease, its progression and related complications, but numerous studies show that awareness of kidney disease at the population level is low. […] Approximately 850 million people worldwide are estimated to have kidney disease, most of whom live in low-income and lower-middle-income countries (LICs and LMICs), and a large proportion of these individuals lack access to kidney disease diagnosis, prevention or treatment. […] Kidney disease is an increasing global problem that disproportionately affects poor, vulnerable and marginalized populations, and is associated with high individual, health care and societal costs. […] The burden of kidney disease is rising worldwide. […] Given its increasing prevalence, if CKD remains largely undetected and is consequently not treated, the numbers of people developing kidney failure and requiring expensive kidney replacement therapy (KRT) will naturally increase.

• #76 Chronic Kidney Disease: Detection and Evaluation | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1215/p776.html

  Because CKD can progress to advanced renal failure, end-stage renal disease, and even death, early detection is critical for initiating timely therapeutic interventions, limiting nephrotoxin exposure, preventing further reduction in GFR, and preparing for renal replacement therapy. […] The U.S. Preventive Services Task Force concluded that the evidence is insufficient to assess the balance of benefits and harms of routine screening for CKD in asymptomatic adults. […] Screening for CKD includes measurement of serum creatinine, estimation of GFR using a serum creatinine-based equation, measurement of the urine albumin/creatinine ratio, and urinalysis. […] Serum cystatin C is a filtration marker that has emerged as an alternative to serum creatinine to more accurately estimate GFR and classify CKD.

• #77 Chronic kidney disease and the global public health agenda: an international consensus | Nature Reviews Nephrology

  https://www.nature.com/articles/s41581-024-00820-6

  The global mortality from all kidney diseases likely ranges between 5 million and 11 million per year and kidney dysfunction is currently the seventh leading risk factor for death. […] Despite being the third fastest-growing cause of death, kidney disease has not received the attention it deserves from governments, multilateral organizations such as the WHO, the lay press or health systems. […] Failure to diagnose CKD is driven by the silent nature of the disease, as well as lack of awareness of the devastating consequences of opportunities missed owing to a lack of timely detection. […] CKD is often caused by pre-existing major NCDs that have been acknowledged by the WHO as priority conditions, such as diabetes, or by risk factors common to heart disease and stroke, such as hypertension.

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