Which organ is primarily affected by end-stage renal disease?

• A. Liver
• B. Kidneys
• C. Heart
• D. Lungs

Answer: (B)

End-stage renal disease represents the final stage of chronic kidney disease in which kidney function falls far below what the body needs. The organ primarily affected is the kidneys themselves; the disease process centers on loss of nephron function and a severely reduced glomerular filtration rate, which eliminates the kidneys’ ability to filter waste, regulate fluids and electrolytes, and produce important hormones. As waste accumulates and fluid/electrolyte balance is disrupted, multiple body systems are impacted, but the defining organ involved is the kidneys. Other organs may show secondary effects due to the systemic consequences, not because they are the primary site of disease.