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End Stage Renal Disease


End stage renal disease, or kidney failure, is generally treated by dialysis or kidney transplant. At this stage of disease, the kidneys aren’t able to function well enough to filter waste and fluids, which can then build up in the body.

WakeMed’s vascular surgeons work with other specialists, including nephrologists, interventional radiologists (for temporary and tunned catheter placement), general surgeons (for peritoneal dialysis access) and cardiologists, to prepare patients to receive dialysis. We are skilled and experienced in creating hemodialysis access, a minor surgery that provides a gateway for a patient’s blood to travel through tubes to a dialysis machine, where it can be cleaned.

Causes of End Stage Renal Disease

End stage renal disease is caused by other health problems that have done permanent damage to the kidneys over time. These causes include:

  • Diabetes
  • High blood pressure
  • Autoimmune conditions
  • Genetic diseases
  • Urinary tract conditions

Symptoms of End Stage Renal Disease

Kidney failure can come on gradually or suddenly. When the kidneys are having problems functioning, symptoms can include:

  • Nausea
  • Vomiting
  • Changes in urination patterns
  • Chest pain
  • Fatigue
  • Loss of appetite
  • Itching
  • Muscle cramps
  • Trouble sleeping

Diagnosing End Stage Renal Disease 

If we suspect end stage renal disease, our doctors will take a detailed health history and perform a thorough physical exam, including looking for signs of problems with the heart and blood vessels.

In most cases, we will also order blood and urine tests, to check for levels of waste products and protein. Imaging scans can also be helpful to look at the structure of the kidneys and can include ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT) scans.  Ultrasound is also utilized to look closely at your veins to see if they are adequate for hemodialysis access creation.

Treating End State Renal Disease 

There isn’t a cure for end state renal disease, but dialysis or kidney transplant can help patients live longer lives.

Hemodialysis is a type of dialysis in which the patient’s blood is cleaned and filtered by a machine, either at home or at a dialysis center.  In cases where hemodialysis is the best option, WakeMed’s vascular surgery team will perform a surgery to create an access site with a fistula or a graft and follow it to make sure it matures. When ready, the dialysis technician will use the vascular access site at the start of each hemodialysis treatment session. 

Make an Appointment

We are welcoming new patients and we accept most insurance plans. If you’d like to meet with one of WakeMed’s vascular experts, please make an appointment by calling us at 919-235-6570 (Cary), 919-350-7600 (East Raleigh), or 919-235-6520 (Midtown Raleigh).  

Vascular Surgery

Schedule an appointment with our experts or talk to your nephrologist about a referral to one of our WakeMed surgeons’ – most of our patients for dialysis access are not self-referred. Call our Cary office at 919-235-6570, our East Raleigh office at 919-350-7600 or our Midtown Raleigh office at 919-235-6520.