Learning About Stage 5 Chronic Kidney Disease

Stage 5 chronic kidney disease is the last stage of chronic kidney disease. At this stage, there is severe kidney damage. The kidneys are close to failure or have already stopped working. When kidney function falls below a certain point, it's called kidney failure. Kidney failure affects your whole body. It can cause serious heart, bone, and brain problems and make you feel very ill. Untreated kidney failure can be life-threatening.

The estimated glomerular filtration rate (eGFR) for stage 5 of chronic kidney disease is less than 15. Glomerular filtration is the process that the kidneys use to filter the blood, removing excess wastes and fluids. The eGFR is a number that shows how well the kidneys filter the blood. This number is used to determine the stage of kidney disease.

Symptoms of stage 5 chronic kidney disease may include:

• Feeling weak and tired.
• Feeling sick to your stomach or vomiting.
• Loss of appetite.
• Trouble breathing.
• Changes in your skin color.
• Making little or no urine.
• Swelling in your arms, hands, legs, or feet.
• Headaches.
• Pain in your lower back.
• Muscle cramps.

Your doctor will ask you about past kidney problems. You will be asked if you have a family history of kidney disease. Your doctor will also want to know what medicines you take. This includes prescription and over-the-counter medicines.

Your doctor will do blood and urine tests to check how well your kidneys are working. This will help your doctor see how well your kidneys filter your blood. You may have other tests to help rule out other problems that could be causing your symptoms.

You also may have a test such as an ultrasound or CT scan. These tests let your doctor look at a picture of your kidneys. This can help your doctor measure the size of your kidneys and see if anything is blocking your urine flow.

In some cases, your doctor may take a tiny sample of kidney tissue (biopsy) to help find out what caused the kidney disease.

At this stage of kidney disease, you will probably have two treatment options: Start dialysis to filter wastes and extra fluid from your blood, or get a new kidney (transplant). Both of these treatments have risks and benefits. You can also choose not to get either treatment. This is known as conservative management or comfort care. It focuses on helping you treat and manage your symptoms. Talk with your doctor to decide which would be best for you.

Your doctor may give you medicines that can help with your symptoms. The doctor may also treat any other health problems that are causing your kidney disease or making it worse. To stay as healthy as possible, work closely with your doctor. And take your medicines exactly the way your doctor says to.

Lifestyle changes are an important part of your treatment no matter what stage of kidney disease you have. Taking these steps can help slow down kidney disease and reduce your symptoms. These steps may also help with high blood pressure, diabetes, and other problems that make kidney disease worse.

• Be active. For many people, walking is a good choice. Try for at least 30 minutes on most days of the week.
• Follow a diet that is healthy for your kidneys. A dietitian can help make an eating plan with the right amount of salt (sodium), protein, and fluids.
• If you smoke, try to quit. If you can't quit, cut back as much as you can. Smoking can make chronic kidney disease worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Avoid medicines that can harm your kidneys. These medicines include nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of these are ibuprofen and celecoxib. Let your doctor know all of the prescription and over-the-counter medicines, vitamins, and herbs you take. And talk to your doctor before you take anything new.
• Avoid or limit alcohol, marijuana, or other drugs. If you need help decreasing your use, talk to your doctor.

Go to all your appointments and follow-up visits. Your doctor will use blood and urine tests to regularly check how well your kidneys are working and decide if you need changes in your treatment plan.