I am CKD 4 (eGFR of 27). Right ureter and kidney removed July 2016 due to TCC (transitional cell carcinoma) linked to bladder cancer (cystectomy performed in February 2015). I am being very careful to adhere to a renal diet, plus I take VALTESSA (potassium binder). I perform aerobic exercise for 45 minutes, 5 -6 days a week. The only symptom I feel is end-of-day fatigue. Before kidney removal, I would go to sleep (after reading) around 11 PM. Up at 7 AM. I'm still up at 7:00, but fade quickly after 9 PM. I'm asleep by 9:30 PM. Have others with Stage 4 CKD experienced what I am? Oh, and I will be 78 in a few months, and I am a male (if that makes any difference).Thanks!