End Stage Renal Disease (ESRD) is commonly used in the context of permanent and irreversible kidney damage i.e. the kidneys fail to do their job and some kind of Renal Replacement Therapy (RRT) is required.
Chronic Kidney Disease (CKD) describes a gradual decline in kidney function over a longer period of time, through five stages. Each of these stages represents the progression of an abnormally low and deteriorating glomerular filtration rate (GFR). The condition is also commonly referred to as kidney or renal failure.
If the failing kidney function is detected early, the patient can be well managed and the symptoms controlled with diet and medication before RRT must be considered. However, if kidney failure progresses insidiously and is undiagnosed, the patient may ultimately need to undergo dialysis.
There are many causes of CKD, and the geographic and demographic variation is significant. Nevertheless, the contribution of type II diabetes to the CKD population is today described as a global dilemma. Other common causes of CKD are persistent high blood pressure, different forms of renal inflammation, injurious toxic substances, and drug toxicity.
Deteriorating kidney function can be followed by measuring the declining level of creatinine clearance. In addition, the concentration of creatinine in the blood increases. Dialysis therapy is usually initiated when creatinine clearance is below 15 ml/min (normally 120 ml/min).
The CKD patient experiences a progressive accumulation of water and waste products and will eventually display a range of signs and symptoms. The patient may complain of swelling and tiredness, and may also suffer from breathlessness. The fluid accumulation that occurs eventually leads to heart enlargement and hypertension. The waste accumulation of uremic toxins may cause headache, nausea, and skin itching.