End Stage Renal Disease is chronic kidney disease that requires treatment with dialysis or kidney transplantation. End stage renal disease is a significant public health problem effecting 300,000 patients in the United States. Several million other patients have earlier stages of chronic kidney disease putting them at risk for end stage renal disease. The most common causes of chronic kidney disease in the US are diabetes and high blood pressure. Patients with diabetes, high blood pressure or a family history of dialysis or transplantation treatment are at risk for chronic kidney disease. Unfortunately, many patients feel well in the early stages of chronic kidney disease, and thus do not become aware of kidney disease until late in the course. Specialized testing of the blood and urine can diagnose chronic kidney disease early and provide an opportunity to prevent progression of disease or slow down the process of decline. The three primary treatment options for patients with end stage renal disease are hemodialysis, peritoneal dialsysis, and kidney transplanation.