End-stage renal disease (ESRD) occurs when the kidneys lose nearly all their ability to function, typically after chronic kidney disease progresses to its final stage. At this point, the kidneys can no longer filter waste and excess fluids from the blood, leading to a dangerous buildup of toxins in the body. Patients with ESRD require dialysis or a kidney transplant to survive. Common causes include diabetes, high blood pressure, and genetic disorders. Symptoms may include fatigue, swelling, and difficulty concentrating. Timely medical treatment of End stage renal disease and lifestyle changes are crucial to managing ESRD effectively.