Living with Stage 4 Chronic Kidney Disease

What is kidney failure?

When you have kidney failure, it means your kidneys are damaged. They cannot do these important jobs well enough. Having kidney failure means that:

• Your eGFR is less than 15

• 85-90% of your kidney function is gone

• Your kidneys don't work well enough to keep you alive

There is no cure for kidney failure, but with treatment it is possible to live a longer life. Having kidney failure is not necessarily a death sentence. People with kidney failure live can active lives and continue to do the things they love.

Check out this video on what will happen if you go into kidney failure.

Knowing the symptoms of kidney failure

Healthy kidneys remove wastes and extra fluid from your blood. But when your kidneys fail, wastes and extra fluid can build up in your blood and make you feel sick. You may have some of the following symptoms:

• nausea

• trouble sleeping

• poor appetite

• weakness

• tiredness

• itching

• weight loss

• muscle cramps (especially in the legs)

• swelling of your feet or ankles

• trouble sleeping

Contact your healthcare team of you have feel any of these symptoms.

When is treatment for kidney failure needed?

Your clinician will help you decide when you need to start treatment. Some of the things the decision is based on can include the following:

• Your symptoms

• Other health problems you have

• How much kidney function you have left

• Your nutritional health

• Lifestyle

• Personal preference

When it comes time to choose a treatment for kidney failure, the decision may often be stressful. Learning as much as you can about your options and talking with your healthcare team to choose a treatment plan that's right for you will help you and your family feel better prepared to make this difficult decision. Each option has different advantages and disadvantages so it is important to learn as much as possible. What might be positive for one person might be a negative for someone else.

How is kidney failure treated?

There are two treatment options for kidney failure: kidney transplantation and dialysis (hemodialysis or peritoneal dialysis).

Transplant means to move from one place to another. For kidneys this means that a healthy kidney is taken from one person’s body and put into someone’s body whose kidneys have stopped working.

Dialysis is a way of cleaning the blood outside the body through a machine. The dialysis machine cleans your body’s blood when your kidneys stop working well.

Overall, kidney transplantation is the recommended treatment option for most people with kidney failure. However, people on dialysis can also have full and happy lives.

Your treatment plan may also include taking medicines, restricting salt, limiting certain foods, getting exercise, and more. You will also need treatment for any other health problems you may have, including high blood pressure or diabetes. Your healthcare team will work with you to develop a treatment plan that's right for you.

How can I know which treatment is right for me?

Talk with your family so you can decide which treatment will best fit your lifestyle needs. Also you always have the choice to change to a different type of treatment in the future. As your needs and your life change over time, so may your treatment. However, there may be medical reasons why a particular treatment option is not right for you, so talk with your healthcare team to discuss your personal needs.

You can ask about visiting a transplant center for an evaluation. Talking to other people who went through the kidney transplant process can also help. If dialysis is an option, you can ask about visiting a dialysis center or talking to other people get dialysis to share their experiences. You can ask your healthcare team for help with this, or contact an organization such as the National Kidney Foundation.

Palliative care

Palliative care is a specialized type of medical care that can help people living with CKD by alleviating pain, other symptoms and stress at the same time they are receiving treatment to cure their disease. Managing care and treatment for kidney disease can be a round-the-clock effort that can put enormous physical and emotional strain on both the patient and the family. Ways that palliative care can offer people with CKD an extra layer of support include the following:

• Manage pain and other conditions related to CKD

• Help with communication with your other doctors and evaluating treatment options

• Explain what to expect throughout the illness

• Help you cope with worry, stress or depression

You can speak with your healthcare team for more information on palliative care.

Treatment for kidney failure: What can I do?

• If you have CKD Stage 4 and are not seeing a nephrologist, then contact your primary care clinician, ask for a nephrology referral, and then make an appointment.

• Ask a clinician about visiting a transplant center

• Ask about visiting a dialysis center, if dialysis is an option

• Talk with your family so you can decide which treatment will best fit your lifestyle needs.

• Learn as much as you can about each treatment option. You can learn more by speaking to your healthcare team. You can also contact an organization such as the National Kidney Foundation.

• Online communities are also available for people to share their experiences, ask questions and get answers.

No matter which treatment you choose, you need to make a commitment to follow your treatment plan. This involves:

• Following your treatment plan or schedule

• Following your special diet

• Taking all your medicines as instructed