Renal & Urology

End-Stage Renal Disease

Kidney failure is stage 5 chronic kidney disease with insufficient renal function to maintain homeostasis; care is planned around symptoms, biochemical complications, patient goals and the choice between dialysis, transplantation and supported conservative management.

Definition

Kidney failure is stage 5 chronic kidney disease, defined by an eGFR below 15 mL/min/1.73 m2 or the need for renal replacement therapy. A person may be managed with haemodialysis, peritoneal dialysis, kidney transplantation or active conservative management according to clinical need and informed preference.

First principles

G5 is a stage, not an automatic dialysis prescription

An eGFR below 15 mL/min/1.73 m2 is kidney failure (G5), but dialysis is not started from this number alone. Symptoms of uraemia, biochemical disturbance, uncontrollable fluid overload, the person's goals and overall clinical condition determine when renal replacement is appropriate.

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