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End-Stage Renal Disease (ESRD) Guide

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Your kidneys filter all the blood in your body every 30 minutes. They remove wastes, toxins, and excess fluid. They also help control blood pressure, stimulate production of red blood cells, keep your bones healthy, and regulate blood chemicals that are essential to life. ESRD is the final stage of kidney disease where your kidneys no longer work as they should to meet your body's needs. When the kidneys lose their filtering abilities, dangerous levels of fluid, electrolytes and wastes can build up in your body. Those with ESRD need dialysis or a kidney transplant to live.

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If you have been diagnosed with kidney disease, you can try to slow its progress by adopting these healthy practices:

  • Adopt a balanced, nutritious and low-sodium diet; limit your protein intake
  • Maintain a healthy weight
  • Control your blood sugar
  • Control and manage your blood pressure
  • Take all medications as prescribed by your doctor
  • Check your cholesterol levels annually
  • Try to stay active every day
  • Do not use smoking or tobacco products
  • Get regular medical checkups

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  • Kidney Transplant: A surgical procedure that removes a healthy kidney from a live or deceased donor and implants it into someone with ESRD. It takes one donated kidney to replace two failing kidneys. A transplant can extend the patient’s life span and quality of life. However, it carries the risk of blood clots, infection and rejection of the donated kidney. It may not be an option for those of advanced age, abuse alcohol or drugs or have been diagnosed with cancer or severe heart disease.
  • Dialysis: A dialyzer (a filtering machine) performs the function of your kidneys when your kidneys can't do it themselves. This device removes extra fluids and waste products from your blood, restoring your electrolyte levels and helping control your blood pressure.

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  • Dialysis Service: Medical care, tests and other treatments for the kidneys. This service includes dialysis supplies and other supplies that help treat the kidneys. We cover the following as prescribed by your treating doctor, when medically necessary: Hemodialysis treatments and Peritoneal dialysis treatments
  • Evaluation and Management Services: Services for doctor’s visits to stay healthy and prevent or treat illness
  • Genitourinary Services: Services to treat conditions, illnesses, or disease of the genitals or urinary system
  • Inpatient Hospital Services: Medical care that you get while you are in the hospital. This includes any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you
  • Laboratory Services: Services that test blood, urine, saliva and other items from the body for conditions, illnesses, or diseases
  • Medication Management Services: Services to help people understand and make the best choices for taking medication
  • Pain Management Services: Treatments for long-lasting pain that does not get better after other services have been provided


  • Weight Loss Health Coaching Sessions: Age 10 years and up. Must submit a consent form, verbally pledge to lose weight within 30 days and complete 6 sessions within 6 months. Earn $20. 
  • Tobacco Cessation Health Coaching Sessions: Age 10 years and up. Must submit a consent form, verbally pledge to stop tobacco use and complete all 4 sessions within 6 months of the first session. $5 reward after each completed session. Earn up to $20.

Learn more about Healthy Rewards.  

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  • Kidney Smart: A kidney disease education program that provides information kidney function and treating kidney failure. This program provides information about health and nutrition, and helps those diagnosed with kidney disease.
  • National Kidney Foundation: A nonprofit, patient-centered organization dedicated to preventing kidney and urinary tract diseases and improving the availability of organs for transplantation. It is the largest organization dedicated to addressing kidney disease in the U.S.
  • NKF Peers: A peer mentoring program under the National Kidney Foundation that helps those diagnosed with kidney disease to speak with trained peer mentors who have experience managing the disease. Peer mentors share their experiences about dialysis, transplant or living kidney donation. After you call or complete the online form, you will speak with an NKF staff member who will ask your questions to match you with a mentor who will be a good fit for you. Call 1-855-653-2273 Monday through Friday, 9 a.m. to 5 p.m. Eastern.
  • Sunshine Health Community Resource Database: Find more free resources through Sunshine Health’s Community Resource Database. Enter your ZIP code to search for help with food, shelter, healthcare, money, school, jobs and more.
  • Sunshine Health offers Case Management for care coordination needs and support with the management of your condition.

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Call Member Services at 1-866-796-0530 (TTY: 1-800-955-8770) Monday through Friday, 8 a.m. to 8 p.m. Eastern.