Which is a leading cause of end-stage renal disease?

• A. Asthma
• B. Diabetes
• C. Liver disease
• D. COPD

Answer: (B)

The key idea is understanding which conditions most commonly progress to end-stage kidney failure. Diabetes mellitus stands out as the leading driver because long-standing high blood glucose damages the kidneys’ filtering units, beginning with glomerular basement membrane thickening and mesangial expansion, and often progressing to nodular glomerulosclerosis. Over years, this diabetic nephropathy reduces filtration ability and leads to end-stage renal disease, typically requiring dialysis or transplantation. Hypertension often accompanies diabetes and speeds this damage, making the combined effect even more impactful, but diabetes itself is the primary trigger.

Asthma and COPD primarily affect the lungs and do not cause the progressive kidney failure that defines ESRD. Liver disease can lead to renal problems in advanced cases (hepatorenal syndrome), but it is not the main cause of ESRD in the general population.