The diagnosis of end-stage renal disease is based on evidence of kidney damage for more than three months, with a GFR less than 15 mL/min/1.73 m². Evaluation involves routine laboratory tests such as a complete blood count (CBC), basic metabolic panel (BMP), urinalysis, and assessment of serum electrolytes, calcium, phosphate, parathyroid hormone (PTH), and vitamin D levels. Imaging studies like renal ultrasound can provide information about kidney size, echogenicity, and structural abnormalities. Renal biopsies may be necessary in unclear cases to determine the exact etiology of kidney failure.
An accurate assessment of GFR is crucial in diagnosing and managing ESRD. Equations such as the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) and MDRD (Modification of Diet in Renal Disease) formulas are commonly used to estimate GFR. Other diagnostic tools, including serum protein electrophoresis, antibody testing, and imaging studies, may be employed to further evaluate specific underlying conditions contributing to renal failure.
