End-stage Renal Disease (ESRD) Home A-Z Health Information Health Library A-Z End-stage Renal Disease (ESRD) Overview End-stage renal disease (ESRD) represents the final stage of CKD, where the kidneys lose their functional reserve and require renal replacement therapies to support daily activities. These therapies include initiation of dialysis or undergoing pre-emptive renal transplantation. Symptoms ESRD may present with:Fluid overload, causing swelling, breathing difficulties, and abdominal distension.Uremic gastritis symptoms such as indigestion, acidity, reduced appetite and itching.Neurological issues like altered sensorium or irrelevant talk due to uremic encephalopathy.Metabolic complications, including hyperkalaemia and metabolic acidosis. Specialist to approach Patients with ESRD should consult a kidney specialist (nephrologist) for optimal management and treatment. Diagnosis Urine tests, blood tests to assess renal function,Ultrasound (USG) for kidney imaging and evaluation Treatment Management of ESRD involves renal replacement therapies, including:Haemodialysis or peritoneal dialysis to support kidney function.Kidney transplantation, which may be performed pre-emptively (before starting dialysis) or after initiating dialysis.