There’s a lot to learn about kidney disease and End Stage Renal Disease (ESRD), also known as kidney failure. Get the answers you need to help make your transition to treatment easier.

What is ESRD?

Kidney disease is usually progressive and is classified into five stages. When the kidneys can no longer clean blood and balance fluids adequately, it is referred to as ESRD. This means you need dialysis treatments to perform the tasks your kidneys can no longer do. Many people continue to live active lives while on dialysis.

Nurse setting up dialysis on patient

Why are your kidneys important?

Your kidneys do many things. They filter waste products, remove extra fluid from your blood and send messages to other organs in your body to help keep you healthy. When your kidneys aren’t able to do their job, fluid and waste build up in your blood. This can make you feel tired, weak and very sick. Without the messages healthy kidneys send to the rest of your body, you may become anemic (low blood count) and bones can become brittle and easy to break.

What causes kidney failure?

The most common causes of kidney failure are related to poorly controlled diabetes and high blood pressure. Other causes include heart disease, autoimmune diseases (such as lupus), genetic diseases (inherited or passed on within the family, such as polycystic kidney disease [PKD]), overuse of certain medications and injury.

What are the symptoms of ESRD?

ESRD usually has no symptoms until it is very far advanced. When your kidney disease is severe, you may experience extreme fatigue, headaches, lack of hunger, nausea, itching, and swelling.

Understanding the role your kidneys play

Your kidneys do more than just clean your blood. They actually make two hormones, one that helps you maintain healthy bones and another that plays a key role in preventing anemia. As a result, many patients on dialysis, as well as patients with Chronic Kidney Disease (CKD), can develop anemia because of their weakened kidney function.

Informed patients are healthier and can more easily adjust to the restrictions associated with having a chronic disease.

Treatment Options

There are two primary categories to consider when treating kidney disease: dialysis and transplant. Dialysis is the process of eliminating waste and unwanted fluid from the blood through a specialized treatment.

ARA offers all modalities, including in-center dialysis, home hemodialysis, and peritoneal dialysis (PD); we may also offer nocturnal dialysis in some facilities. Your nephrologist determines the length of each dialysis treatment, which varies based on individual needs and the treatment type. Speak with your nephrologist to determine the treatment type most suits you.

kidney transplant involves getting a kidney from another person surgically placed in your body. A transplant requires a referral to a special center and several blood and x-ray tests to be accepted to the waiting list to receive a kidney. Some patients, after testing, may find they have someone who can donate a kidney to them; this is called a living donor.


There are several types of dialysis, each of which are called a “modality.” All provide excellent options for treatment.

In-center dialysis

In-center dialysis requires patients to go to a dialysis clinic, generally three times per week, to be connected to a dialysis machine. This machine cycles blood through a special filter, called a dialyzer, that removes waste and excess fluid from the blood. Specially trained staff monitor patients during in-center dialysis treatments.

Learn more about in-center dialysis >

Home hemodialysis

Very similar to in-center dialysis, but in home dialysis the patient, along with a care partner, are trained to perform the dialysis treatment at home.

Peritoneal dialysis (PD)

This is a needle-free approach that uses a patient’s abdomen as a filter and gives patients the freedom to perform the procedure at home or in other suitable locations. Our staff provides specialized training so you can safely perform Peritoneal Dialysis.

Nocturnal dialysis

Nocturnal dialysis gives patients the option to have dialysis treatments at night. These treatments are done at the dialysis clinic, and many patients will sleep there overnight while being dialyzed.

Kidney Disease Resources

The Stages of Chronic Kidney Disease  | Stages 1 & 2  |  Stage 3  |  Stage 4  |  Stage 5

“You’ll never find the quality of care that you get at an ARA facility anywhere else. The staff always have your best interest at heart and will go out of their way to make you feel comfortable and help however they can. The truth is, I consider them my extended family!” 

Mr. Randal Beatty, University Kidney Center Hikes Lane, Louisville, KY