What Happens to Your Kidneys During the Last Stages of Renal Failure?

End-stage renal disease, or ESRD, develops when kidney failure is so severe that the organs can no longer perform functions essential to daily life, such as filtering waste out of blood and regulating urination, Healthline states. Doctors diagnose this stage when healthy kidney function is reduced to less than 10 percent efficiency. Patients typically need a kidney transplant or hemodialysis treatment, which requires a machine to assume the functions of the kidneys.

Chronic kidney disease often develops progressively over a 10- to 20-year period before ESRD occurs, according to MedlinePlus. At this stage, the kidneys may partially or completely lose the ability to make urine, and people may experience persistent fatigue, headaches, nausea, dry skin and unexplained weight loss. Skin discoloration, excessive thirst, edema, muscle cramps and breath odor are also symptoms. Some people struggle with nosebleeds, sexual impairment, difficulty sleeping, and numbness and cramps.

When kidneys are overwhelmingly diseased, doctors may recommend surgical removal of both organs, and the patient receives one healthy kidney from a donor, Healthline notes. Since kidneys are available from living donors, doctor perform these transplants more frequently than many other in-demand surgeries. Patients prescribed hemodialysis typically receive treatment three times weekly, and a machine carefully extracts waste particles and recirculates clean blood into the body. An alternative therapy, known as peritoneal dialysis, involves abdominal injections.