Learning About Stage 4 Chronic Kidney Disease

Stage 4 chronic kidney disease is one of the five stages of chronic kidney disease. At this stage, there is moderate to severe kidney damage. This means your kidneys don't work as well as they should.

Kidneys remove waste products and extra fluids from your blood and flush them from your body as urine. When your kidneys don't work right, wastes build up in your blood and make you sick. This can cause problems such as high blood pressure, anemia, problems with your bones, and heart disease. Stage 4 is the last stage before kidney failure.

The estimated glomerular filtration rate (eGFR) for stage 4 of chronic kidney disease is from 15 to 29. Glomerular filtration is the process that the kidneys use to filter the blood, removing wastes and excess 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 4 chronic kidney disease may include:

• High blood pressure.
• Anemia.
• Bone disease.
• Feeling weak and tired.
• Swelling in your arms or legs.
• Pain in your lower back.
• Muscle cramps.
• Feeling sick to your stomach or vomiting.
• Loss of appetite.

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.

Chronic kidney disease is usually caused by another condition. So the first step is to treat the disease that is causing kidney damage.

Diabetes and high blood pressure cause most cases of chronic kidney disease. If you keep your blood pressure and blood sugar in a target range, you may be able to slow or stop the damage to your kidneys. Losing weight and getting more exercise can help. You may also need to take medicines.

Chronic kidney disease is a complex problem. You will probably need to take a number of medicines and have many tests when you have kidney disease. 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. 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 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.