Chronic, advanced kidney disease that needs renal dialysis or a kidney transplant to prevent imminent death. Individuals who have chronic kidney disease requiring dialysis or kidney transplant are considered to have ESRD. To qualify for Medicare coverage, an individual must be fully or currently insured under Social Security or the railroad retirement system or be the dependent of an insured person. Eligibility for Medicare coverage begins with the third month after the beginning of a course of renal dialysis. Coverage may begin sooner if the patient participates in a self-care dialysis training program or receives a kidney transplant without dialysis.