The end result of many renal diseases -- whether they are renal vascular diseases, glomerulonephritis, or chronic pyelonephritis--is end stage renal disease (ESRD). In ESRD, the kidneys are small bilaterally, as shown here. This condition is associated with chronic renal failure, and the patient's blood urea nitrogen (BUN) and serum creatinine continue to increase. Chronic renal failure can be treated by dialysis or by kidney transplantation, as shown here. Note the normal size of the pre-owned kidney in comparison with native diseased kidneys.