End-Stage Kidney Disease (ESKD) represents the final stage of chronic kidney disease, in which kidney function is severely reduced and no longer sufficient to sustain life without advanced renal support. ESKD is increasingly prevalent in the UAE due to rising rates of diabetes, hypertension, and long-standing chronic kidney disease.

At this stage, the kidneys lose their ability to remove waste products, regulate fluid balance, maintain electrolyte stability, and support essential hormonal functions. As a result, toxins accumulate in the body, fluid overload develops, and life-threatening metabolic disturbances occur.

Patients with ESKD commonly experience profound fatigue, loss of appetite, nausea, itching, swelling, shortness of breath, and changes in mental clarity. Blood pressure often becomes difficult to control, and complications such as anemia, bone disease, and cardiovascular disease are common.

Diagnosis is established through persistently low estimated glomerular filtration rate (eGFR), abnormal laboratory findings, and clinical symptoms. At this stage, conservative measures alone are no longer sufficient.

Management of ESKD requires renal replacement therapy, most commonly dialysis. Hemodialysis and peritoneal dialysis are the primary treatment options used to remove waste products and excess fluid from the blood. In selected patients, supportive conservative care may be chosen based on overall health and patient preference.

Nephrologists play a central role in coordinating dialysis care, managing complications, and optimizing quality of life. Multidisciplinary support including dietetics, nursing, and patient education is essential for long-term management.

With appropriate treatment and close monitoring, many patients with ESKD are able to maintain stability and functional independence. Early preparation and timely referral to nephrology services significantly improve outcomes.