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

Diabetic nephropathy is considered the most common cause of end-stage renal disease (ESRD) due to the growing prevalence of diabetes mellitus, particularly type 2 diabetes. In individuals with diabetes, prolonged high blood glucose levels can lead to damage in the kidneys' filtering units, known as nephrons. Over time, this damage can progress to significant impairment in kidney function.

The pathophysiology includes changes in renal blood flow and increased pressure in the glomeruli, leading to proteinuria and an eventual decline in the glomerular filtration rate (GFR). As the condition progresses, the kidneys lose their ability to filter waste and excess fluid, ultimately leading to ESRD, which requires dialysis or transplantation for life-sustaining treatment.

This underlines the importance of early detection and management of diabetes to prevent or delay the onset of diabetic nephropathy and subsequent kidney failure.