End-stage renal failure, also known as end-stage renal disease (ESRD), is the final, permanent stage of chronic kidney disease, where kidney function has declined to the point that the kidneys can no longer function on their own. A patient with end-stage renal failure must receive dialysis or kidney transplantation in order to survive for more than a few weeks.

Patients may experience a wide variety of symptoms as kidney failure progresses. These include fatigue, drowsiness, decrease in urination or inability to urinate, dry skin, itchy skin, headache, weight loss, nausea, bone pain, skin and nail changes and easy bruising.

Doctors can diagnose the disease with blood tests, urine tests, kidney ultrasound, kidney biopsy, and CT scan.

According to the National Center for Chronic Disease Prevention and Health Promotion, about 30 million people, or 15% of adults, in the U.S. are estimated to have chronic kidney disease. Chronic kidney disease can often be treated before it progresses to end-stage renal failure or leads to other health problems.

Some of the risk factors for developing chronic kidney disease—that could ultimately lead to end-stage renal failure—include diabetes, high blood pressure, heart disease, drug abuse, blockages in the urinary tract, family history, inflammation, and some genetic disorders. Additionally, having chronic kidney disease and not properly managing it can cause the disease to progress to the point that it becomes end-stage.