End-Stage Renal Disease (ESRD)

A condition of permanent RENAL FAILURE in which the KIDNEYS can no longer function to filter wastes from the BLOOD. People who have ESRD require ongoing RENAL DIALYSIS and may be appropriate candidates for KIDNEY TRANSPLANTATION. DIABETES, HYPERTENSION (high BLOOD PRESSURE), and GLOMERULONEPHRITIS are the most common causes of ESRD in the United States. About 300,000 Americans live with ESRD, about 15,000 of whom undergo kidney transplantation each year. ESRD typically follows a period of chronic renal failure that extends for years to several decades. More than 40 percent of Americans who have ESRD are between the ages of 45 to 64.

About a third of people who have ESRD survive five years on renal dialysis, whereas 80 to 90 percent who receive transplanted kidneys live five years after the transplant operation, the five-year marker being a key assessment point for the success of treatment. The waiting list for a cadaver donor kidney (a kidney donated after a person’s death) varies widely because donors and recipients must match, and it can be two or three years before one receives a kidney because the supply of donor organs is so limited. An increasingly popular option is living donor transplantation, in which a person (often a family member) who provides a close match for BLOOD TYPE and blood antigens and has two healthy kidneys donates one kidney for transplantation into the person who has ESRD. Each year in the United States nearly 80,000 people die from ESRD.

The U.S. federal government’s health-care program for older Americans, Medicare, extends coverage to those of any age who have ESRD. Medicare covers many though not all the costs of renal dialysis and kidney transplantation. Private health insurance and state-funded programs may provide further benefits for those who qualify.


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