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End-stage Renal Disease

End-stage renal disease (kidney failure) is when a person’s kidneys are no longer working well enough for them to live without dialysis or a kidney transplant.


The most common causes of end-stage renal disease are diabetes and high blood pressure as these conditions can affect one’s kidneys. End-stage renal disease almost always comes after chronic kidney disease. The kidneys may slowly stop working over 10 to 20 years before end-stage disease results.

Risk Factors

Factors that may increase your chance of getting end-stage renal disease include:

  • Diabetes
  • High blood pressure
  • Heart disease
  • Smoking
  • Obesity
  • Family history of kidney disease
  • Age 60 or older


Signs and symptoms of end-stage renal disease may include:

  • General ill feeling and fatigue
  • Decreased or no urin output
  • Itching and dry skin
  • Headaches
  • Weight loss without trying
  • Loss of appetite
  • Nausea


To determine if a patient’s chronic kidney disease has progressed to end-stage renal disease, a health care provider will perform a physical exam and conduct blood tests.  Also, patients with end stage renal disease produce much less urine and in some cases urine production stops completely.

Treatments Offered at the Center for Vascular and Endovascular Surgery

The following procedures are offered for the treatment of peripheral arterial disease depending on a patient’s diagnosis

  • Arteriovenous fistula (AV fistula). This is a connection made by a vascular surgeon between an artery (which carries blood away from the heart) and a vein (which carries blood back to the heart). This artificial connection allows the vein to become larger and for the walls of the vein to thicken, a process termed maturation. A mature fistula makes it easier for the vein to be punctured repeatedly for dialysis.
  • Arteriovenous graft (AV graft). If a patient isn’t considered a good candidate for an AV fistula, an AV graft is considered. An AV graft is a piece of artificial tubing, that is attached on one end to an artery, and on the other end to a vein. The tube is placed entirely under the skin and the tube itself is punctured during dialysis.
  • Hemodialysis access maintenance (fistulagram). This is an X-ray study of your fistula. Fistulagrams can detect problems such as a clot or narrowing of the vessels. Early detection and treatment can improve a patient’s fistula’s performance and decrease future complications.


Treating chronic kidney disease may delay or prevent the progression to end-stage renal disease. But, some cases may not be preventable.

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At the Center for Vascular and Endovascular Surgery, every patient meets with one of our highly skilled, board-certified surgeons.

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Vascular disease comes in many different forms and our world class surgeons are experts at diagnosing and treating a wide-spectrum of vascular diseases

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Many patients who come to the Center for Vascular and Endovascular Surgery at St. Elizabeth's have a story to share about their care, recovery, and success after surgery or other treatments.

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Center for Vascular and Endovascular Surgery
St. Elizabeth's Medical Center
736 Cambridge Street
Brighton, MA 02135

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