From the Research
Elevated creatinine in the setting of CKD stage 5 is called end-stage renal disease (ESRD) or kidney failure. This represents the most advanced stage of chronic kidney disease, where kidney function has deteriorated to less than 15% of normal capacity (GFR <15 mL/min/1.73m²) 1. At this stage, the kidneys can no longer effectively filter waste products like creatinine from the blood, resulting in their accumulation to dangerously high levels. Patients with ESRD typically require renal replacement therapy in the form of dialysis (hemodialysis or peritoneal dialysis) or kidney transplantation to sustain life. Without these interventions, uremic toxins including creatinine continue to build up, leading to uremic syndrome with symptoms such as nausea, vomiting, fatigue, confusion, and eventually death. The elevated creatinine is a direct reflection of the kidney's inability to excrete this muscle breakdown product, making it a reliable marker for assessing the severity of kidney dysfunction in advanced CKD.
Some key points to consider in the management of ESRD include:
- The importance of renal replacement therapy in sustaining life 1
- The need for careful monitoring of uremic toxins, including creatinine, to assess the severity of kidney dysfunction 2
- The potential benefits and risks of different dialysis modalities, including hemodialysis and peritoneal dialysis 1
- The role of kidney transplantation as a treatment option for ESRD
It is essential to note that the management of ESRD requires a comprehensive approach, taking into account the patient's overall health, medical history, and quality of life. By prioritizing morbidity, mortality, and quality of life, healthcare providers can provide optimal care for patients with ESRD.