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Blog: Stories and Insight

End-Stage Kidney Disease: What is It & What to Expect



Also known as end-stage renal disease (ESRD), end-stage kidney disease is when the kidneys lose the ability to function and filter excess fluids from the blood, creating a build-up within the body. It is the final stages of chronic kidney disease.

When your kidneys fail, it means they have stopped working well enough to survive without dialysis or a kidney transplant.

In cases when people are unable to receive dialysis or a transplant, or these treatments may not work, patients can choose hospice care. Hospice helps keep patients comfortable by controlling pain and other symptoms.

Symptom relief is essential to end-stage kidney-disease patients, as their quality of life is often reduced by multiple symptoms including fatigue, cramping, and more.


If you live in South Jersey and have questions about end-stage kidney disease
or  hospice care for your loved one, please call Samaritan at (800) 229-8183.


What are the Symptoms of End-Stage Kidney Disease?

Kidney disease usually progresses slowly, and you may not have symptoms until the disease is severe. Symptoms can include:

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Changes in how much you urinate
  • Decreased mental sharpness

Complications of End-Stage Kidney Disease

Common complications of end-stage kidney disease include:

  • gout
  • anemia
  • bone disease
  • heart disease
  • high potassium
  • fluid build up

How Palliative and Hospice Care Can Help

People with end-stage kidney disease can benefit from palliative or hospice care, which focus on relieving symptoms and maximizing quality of life.

Palliative care can be given at any time during the course of kidney disease (or other serious illness). Hospice care is available to people whose life expectancy is six months or less.

For instance, palliative/hospice providers can help address:

  • Pain. Up to half of patients on dialysis have problems with pain. Palliative/hospice providers can prescribe opioids that are safe for people with end-stage kidney disease. Fentanyl and methadone are considered the safest for these patients.
  • Severe itching. Providers can prescribe medications to reduce this challenging symptom.
  • Palliative/hospice providers can determine the cause of the fatigue, such as anemia or depression, and provide appropriate treatment.
  • Providers can treat this symptom with medication.
  • Shortness of breath. Palliative/hospice providers can ensure optimal fluid balance, and encourage physical activity in those who are capable. They can provide opioids as needed at the end of life.
  • Other physical symptoms, including dry mouth, swelling, muscle cramps, restless leg syndrome, lack of appetite, and difficulty sleeping.
  • Emotional symptoms, including depression and anxiety.
  • Psychosocial needs, including decision-making and family communication issues.

Read more about the benefits of hospice care at home. |

Palliative/hospice providers can help patients and families make decisions about care. These decisions are especially important for older patients and those with multiple serious illnesses. In each situation, palliative/hospice providers can provide expert counselling to patients and families, and offer alternatives to dialysis that help patients stay as healthy as possible. Furthermore, hospice offers emotional and spiritual support to patients and families as they make these difficult decisions.

If you live in South Jersey and have questions about end-stage kidney disease
or  hospice care for your loved one, please call Samaritan at (800) 229-8183.