End Stage Renal Disease Stage 5 of chronic kidney disease, also known as end stage renal disease (ESRD), is when the kidneys function below 10 to 15 percent of their normal capacity. This is called kidney failure. In most cases, kidney failure happens after years of living with chronic kidney disease. Less commonly kidney failure occurs suddenly and this is called acute kidney failure. Regardless of cause, once a patient is in kidney failure they will require kidney replacement therapy (dialysis) and/or a kidney transplant. Dialysis Click here to learn more about how dialysis works, treatment options and resources available to patient on dialysis. Transplant Click here to better understand the kidney transplant process and find helpful resources for both transplant patients and living donors.