When CKD has reached an advanced stage in which the kidneys are no longer able to work it is called end-stage renal disease (ESRD). Symptoms at this time become more pronounced and can include a loss of appetite, nausea, vomiting, problems sleeping, changes in urination quantity, fatigue, and itching. At this late stage of the disease dialysis or a kidney transplant are required to survive, however many people live long lives with such treatment. In 2016, there were over 726,000 prevalent cases of ESRD in the U.S. Kidney disease remains one of the leading causes of death in the U.S., with death rates among older adults with CKD significantly higher than among those older adults without the disease.
The most common causes of kidney disease are diabetes and high blood pressure. In the U.S. in the period from 2013 to 2016, it was estimated that almost 36 percent of those with CKD also had diabetes, while 31 percent had hypertension and 17 percent were obese. Cardiovascular conditions are also more common among those with CKD, with almost 65 percent of older adults with CKD reporting some cardiovascular disease, compared to just 32 percent of adults without CKD. As there is no cure for kidney disease, kidney transplants remain one of the most common types of organ transplantations in the U.S., second only to liver transplants.