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Nutrition plays an essential role in sustaining quality of life for those who require care for complex conditions. Pentec Health provides personalized clinical nutrition solutions and superior community-based care.

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Managing the multifaceted needs for a variety of conditions requiring clinical nutrition and specialty care therapies, services and products. This includes patients with kidney disease, kidney failure, chronic, non-healing wounds, gastrointestinal conditions, rare metabolic disorders, chronic pain, muscle spasticity or cancer within or that has metastasized in the liver.

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March 1, 2026 / Blogs

What is End Stage Renal Disease?

For many, kidney health is not something they think about until something goes wrong. Knowing how kidney disease progresses can help identify when it’s time to seek care. End stage renal disease (ESRD), also known as kidney failure, represents the final, permanent stage of chronic kidney disease (CKD). At this stage, the kidneys can no longer function well enough to support the body’s needs on their own.

While a diagnosis of ESRD is life-changing, understanding the condition, its causes, and the available treatment options is the first step in managing health and maintaining quality of
life.

What causes end stage renal disease?

Healthy kidneys function as the body's filtration system, removing waste and excess water from the blood while balancing essential minerals. When kidneys are damaged, they lose this ability over time. ESRD typically occurs when kidney function drops to below 17 percent of normal capacity.1 This affects more than half a million people in the United States alone.1

The damage that leads to ESRD is usually gradual, often taking 10 to 20 years to develop.2 The two most common causes 3,4 are:

  • Diabetes: Both type 1 and type 2 diabetes can damage the filtering units of the kidney due to high blood sugar levels.
  • High blood pressure (hypertension): Over time, uncontrolled high blood pressure can damage the small blood vessels in the kidneys, reducing their ability to filter blood effectively.

Other conditions that can lead to ESRD include:

  • Polycystic kidney disease: A genetic disorder that causes cysts to grow in the kidneys.
  • Glomerulonephritis: Inflammation of the kidney's filtering units.
  • Prolonged obstruction: Conditions such as kidney stones or an enlarged prostate that block the urinary tract.

Recognizing the symptoms

Because the kidneys are highly adaptable, significant damage can occur before symptoms become obvious. However, as the condition progresses to failure, waste products and fluid buildup in the body, leading to noticeable signs.

Common symptoms associated with kidney failure include

  • Nausea and vomiting
  • Fatigue and weakness due to anemia
  • Changes in urination (urinating more or less than usual)
  • Swelling (edema), particularly in the feet and ankles
  • Muscle cramps
  • Itching

If you experience these symptoms, especially if you manage diabetes or high blood pressure, it is crucial to consult a healthcare provider.

Treatment options for kidney failure

Once ESRD is reached, the damage is irreversible. However, treatments are available to replace the lost kidney function and keep the body balanced. There are two primary paths for treatment: dialysis and kidney transplant.

Dialysis

Dialysis is a procedure that artificially removes waste products and excess fluid from the blood when the kidneys can no longer do so. There are two main types:

  1. Hemodialysis: A machine filters the blood outside the body. This is often done at a dialysis center or can be performed at home with training.
  2. Peritoneal dialysis: This method uses the lining of the abdomen (the peritoneum) to filter the blood inside the body. A cleaning solution flows into the abdomen through a catheter, absorbs waste, and is then drained away.

Kidney Transplant

A kidney transplant involves surgically placing a healthy kidney from a donor into the
patient's body. While this can offer a life free from dialysis, it requires finding a
matching donor and taking anti-rejection medications for life.

The challenge of malnutrition in ESRD

Managing diet is a critical component of treating ESRD. Patients on dialysis face a unique challenge known as Protein Energy Wasting (PEW), where the body’s protein and energy stores are depleted. These patients require 20% more protein than people without kidney disease.5 This happens for several reasons, including the dialysis process itself, which can remove essential nutrients along with waste.

To understand why nutrition is so critical for dialysis patients and how clinical malnutrition impacts outcomes, read our in-depth article, “Why Nutrition in Dialysis Matters”.

How specialized nutrition support can help

For patients who cannot meet their nutritional needs through an oral diet alone, specialized therapies such as Intradialytic Parenteral Nutrition (IDPN) and Intraperitoneal Nutrition (IPN) can provide a lifeline. These therapies deliver protein and nutrients directly into the body during dialysis treatment, bypassing the digestive system to ensure the body gets the fuel it needs.

Pentec Health specializes in these renal nutrition therapies, offering formulations tailored to the specific needs of each patient.

For a detailed explanation of how these therapies work and the differences between them, visit our guide: “IDPN & IPN, What's the Difference?”

Supporting your journey

End stage renal disease is a complex condition, but you do not have to navigate it alone. Whether you are exploring treatment options or looking for nutritional support to improve your energy and strength on dialysis, Pentec Health is here to help.

If you or a loved one is struggling with malnutrition related to kidney failure, speak with your healthcare provider or contact Pentec Health to learn how our renal nutrition services can support your care team.

  1. Rout, Preeti, and Ahsan Aslam. ‘End-Stage Renal Disease’. StatPearls, StatPearls Publishing, 2025. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK499861/.
  2. End-Stage Kidney Disease: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000500.htm. Accessed 4 Feb. 2026.
  3. ‘End-Stage Renal Disease - Symptoms and Causes’. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532. Accessed 4 Feb. 2026.
  4. Kidney Failure (ESRD) - Symptoms, Stages, & Treatment | National Kidney Foundation. https://www.kidney.org/kidney-topics/kidney-failure. Accessed 4 Feb.2026.
  5. Lambert, Kelly et al. “Commentary on the 2020 update of the KDOQI clinical practice guideline for nutrition in chronic kidney disease.” Nephrology (Carlton, Vic.)
    vol. 27,6 (2022): 537-540. doi:10.1111/nep.14025.

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