CHRONIC KIDNEY DISEASE Stages 4 and 5

Chronic Kidney Disease Stage 4 and 5 involves significant kidney damage and decrease in glomerular filtration rate (GFR).

Stages	Description	GFR
4	Severe kidney damage with significant decrease in GFR	​29 - 15 ml/min
5	Kidney failure	​less than 15 ml/min

Signs and symptoms of chronic kidney diseases develop over time and progresses slowly. Signs and symptoms may be nonspecific. This may include:

• fatigue and tiredness

• fluid retention usually in the extremities (hands, feet, ankles)

• puffiness around the eyes

• difficulty breathing

• changes in your urination (color, amount, frequency)

• anemia (low red blood cell count)

• high blood pressure

• itchy skin

• decrease appetite

• nausea, upset stomach and poor digestion

• poor nutritional health

• muscle cramps and twitching

• weak bones and increase risk for bone fractures

• skin color changes

• easy bruising and bleeding

• mental symptoms decrease ability to concentrate, confusion

• decrease sexual interest

• changes in your menstrual cycle

Treatment for CKD Stages 4 and 5

Treatment for CDK Stages 4 and 5 is individual based and varies. Treatment options may include diet modifications and medication, hemodialysis, peritoneal dialysis, kidney transplant, or no treatment. Each of the methods must be looked at for each individual because of the individual disease, physical condition, emotional condition, or family situation. However, you should be aware of all methods and should discuss them with your physician. A long-term treatment plan or program can be developed best suited for you.

Anemia in Chronic Renal Disease

In addition to all the functions that your kidney performs, they also make a hormone that controls the production of red blood cells. This hormone is called erythropoietin (EPO). Almost all of your body's EPO is made in the kidneys. In reduced kidney function, the kidneys may not make enough EPO producing cells. When your EPO is low, your body may not make enough red blood cells and as a result you become anemic.

Anemia caused by lack of or not enough EPO, can be treated with EPO injections prescribed by your physicians.

Anemia cause fatigue and low energy. Anemia may also be caused by low levels of iron, folic acid, and bleeding problems. Consult with your healthcare provider for proper diagnosis and treatment of anemia.

Definitions

Glomerular Filtration Rate (GFR)	GFR is a blood test measurement of kidney function used to determine the risk of kidney disease.
Hemodialysis	Hemodialysis is usually done in a dialysis center. With hemodialysis, the patient is connected to a kidney machine (hemodialysis machine). The machine will clean the waste products from your blood by using a filter called a hemodialyzer or artificial kidney. The machine also removes extra fluid from your body. The average hemodialysis treatment lasts from 3 - 5 hours and usually needed three times a week.
Peritoneal Dialysis (PD)	PD is a method of removing waste from your blood with a small, soft, flexible, plastic tube called a catheter which is surgically placed in the lower abdomen. When peritoneal dialysis is done, a sterile cleansing fluid called dialysate is placed in the peritoneal cavity through the catheter. The body's own natural peritoneal membrane acts as a filter to remove waste from the blood. The waste material from the blood passes through the peritoneal membrane into the dialysate. When the filtering process is done, the cleansing fluid or dialysate is let out of the body through the catheter. The number of times the treatment must be performed varies with the type of peritoneal dialysis used. There are several types of peritoneal dialysis: Intermittent Peritoneal Dialysis (IPD), Continuous Cycling Peritoneal Dialysis (CCPD), and Continuous Ambulatory Peritoneal Dialysis (CAPD).
Renal (Kidney) Transplant	Renal (Kidney) Transplant is the placement of a kidney from another person (donor) into a patient with kidney failure through surgical procedure.