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End-Stage Renal Disease

The function of the kidneys is to filter the blood of toxins, control blood pressure and excrete urine. It controls the amount of water in the body by controlling the amount of sodium in the blood. It also produces a number of hormones, including erythropoietin which stimulates the bone marrow to make red blood cells.

The kidneys can be damaged via several mechanisms. The two most common causes of kidney failure are hypertension and diabetes. There are several other mechanisms of injury including atherosclerosis causing occlusion of the arteries to the kidneys, infection, immunologic factors and obstruction of the collecting systems.

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When the kidney function has diminished to less than 10%, they can no longer support all of the functions that the body requires. This means that toxins and fluids can accumulate within the bloodstream. These can approach dangerous levels and become a threat to life.

To counteract this, patients can be placed on dialysis which allows for artificial filtration of the blood. Once committed to dialysis, patients will generally require sessions three times per week to clean the blood. One alternative to dialysis is a kidney transplant which is a good choice for healthy patients with a matching donor.

In order to receive dialysis, access to the blood stream must be created. This can be done in a variety of ways. (See Dialysis Access)

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