Overview
What Kidney Failure Changes
End stage kidney disease (ESKD) means an estimated glomerular filtration rate (eGFR) below 15 mL/min/1.73 m² or the presence of uremic symptoms.
End-stage kidney disease (ESKD) means an estimated glomerular filtration rate (eGFR) below 15 mL/min/1.73 m² or the presence of uremic symptoms. Chronic hemodialysis may be recommended when eGFR is 10 mL/min/1.73 m² or lower, but the clinical picture matters more than the number alone. Refractory fluid overload, severe hyperkalaemia, metabolic complications, or uraemic symptoms such as worsening nausea, confusion, pericarditis, or profound fatigue can make dialysis urgent. Healthy kidneys regulate water, potassium, acid-base balance, and waste removal. They also contribute to erythropoietin production and phosphate regulation. Hemodialysis replaces part of the filtration function, but it does not restore every renal function. This is why a patient may still require treatment for anaemia, mineral-bone disorder, hypertension, and nutrition after dialysis begins. During treatment, blood travels through an extracorporeal circuit and a dialyzer. A semipermeable membrane separates the blood from dialysate. Solutes such as urea and potassium move down concentration gradients into the dialysate, while ultrafiltration uses pressure across the membrane to remove water. The prescription determines the treatment time, dialysate composition, blood-flow rate, and fluid-removal goal. That fluid removal is the...