What is the most common cause of end-stage renal disease?

What is the most common cause of end-stage renal disease?

• A. Diabetes mellitus
• B. Hypertension
• C. Glomerulonephritis
• D. Polycystic kidney disease

Answer: (A)

The key idea is that long-standing diabetes causes diabetic nephropathy, which is the most common reason people progress to end-stage renal disease. Chronic hyperglycemia damages the small vessels in the kidneys, leading to thickening of the glomerular basement membrane, mesangial expansion, and nodular glomerulosclerosis. This damage starts with microalbuminuria, advances to overt proteinuria, a falling glomerular filtration rate, and often hypertension, ultimately resulting in ESRD requiring dialysis or transplant. Hypertension, glomerulonephritis, and polycystic kidney disease can contribute to kidney failure, but diabetes is the leading underlying cause in many populations, making it the best answer.

The key idea is that long-standing diabetes causes diabetic nephropathy, which is the most common reason people progress to end-stage renal disease. Chronic hyperglycemia damages the small vessels in the kidneys, leading to thickening of the glomerular basement membrane, mesangial expansion, and nodular glomerulosclerosis. This damage starts with microalbuminuria, advances to overt proteinuria, a falling glomerular filtration rate, and often hypertension, ultimately resulting in ESRD requiring dialysis or transplant. Hypertension, glomerulonephritis, and polycystic kidney disease can contribute to kidney failure, but diabetes is the leading underlying cause in many populations, making it the best answer.