What is chronic kidney disease stage 5?

Chronic Kidney Disease Stage 5

End-stage renal disease: Overview

End-stage renal (or kidney) disease happens when your kidneys can no longer do their jobs. They can't remove waste from your blood. And they aren't able to balance your body's fluids and chemicals.

This stage of the disease usually occurs after you have chronic kidney disease for years. Now the kidneys work so poorly that you need dialysis or a kidney transplant to live. Dialysis is a treatment to help filter waste from your blood. A transplant is surgery to give you a healthy kidney from another person.

Kidney failure

Kidney failure caused by chronic kidney disease occurs when kidney damage is so severe that a person needs dialysis or a kidney transplant to maintain life. Kidney failure often occurs after kidney damage has been present for 10 years or more.

Diabetes and high blood pressure are the most common causes of kidney failure in the United States.

Kidney failure can be measured by how well the kidneys are able to filter wastes from the blood. This is called the estimated glomerular filtration rate, or eGFR. Kidney failure usually occurs when the eGFR falls to below 15% of what is expected in a person with normal kidney function.

Kidney failure is treated with dialysis, which helps filter waste products from the blood when the kidneys are not working properly, or with kidney transplant.

How is kidney failure treated?

When you have kidney failure, you will probably have two choices: start dialysis or get a new kidney (transplant). Both treatments have risks and benefits.


Dialysis is a process that does the work of healthy kidneys. It filters your blood when your kidneys no longer can. And it works to restore the proper balance of chemicals (electrolytes) in the blood. You may use dialysis for many years. Or it may be a short-term measure while you wait for a kidney transplant.

Dialysis isn't a cure for kidney failure. But it can help you feel better and live longer.

Kidney transplant

Kidney transplant may be the best choice if you are otherwise healthy. With a new kidney, you will feel much better and will be able to live a more normal life. But there are some drawbacks.

  • You may have to wait for a kidney that is a good match for your blood and tissue type.
  • You will have to take medicine for the rest of your life to keep your body from rejecting the new kidney.

Making decisions

Making treatment decisions when you are very ill can be hard. It's common to feel fearful and worried about the risks involved. Discuss your concerns with your family and your doctor. It may be helpful to visit the dialysis center or transplant center and talk to others who have chosen these options.

Many people have successful kidney transplants or live for years using dialysis. But at this point you may decide to talk with your family and doctor about health care and other legal issues that arise near the end of life.

What tests are done when you have end-stage renal disease?

Your doctor will do regular blood tests to check on how you're doing. The tests help your doctor know if you need any changes in your treatment. Blood tests measure:

  • Levels of waste products and electrolytes in your blood that should be removed by your kidneys. These include creatinine, blood urea nitrogen (BUN), potassium, and calcium.
  • Your parathyroid hormone (PTH) level.
  • Your red blood cells, to see if you have anemia of chronic kidney disease. Your doctor can use repeat complete blood cell count (CBC) tests to see if anemia treatment is working.

How can you care for yourself when you have end-stage renal disease?

When you're living with end-stage renal disease, making healthy choices can help you feel better.

These steps may also help with high blood pressure, diabetes, or other problems that make kidney disease worse.

  • Follow a diet that is easy on your kidneys. A dietitian can help you make an eating plan with the right amounts of salt (sodium), potassium, and protein. You may also need to limit how much fluid you drink each day.
  • Be active every day that you can, in any way that you can. Work with your doctor to decide what level of activity is right for you.
  • Do not smoke or use tobacco.
  • Limit alcohol.

Some medicines can hurt your kidneys. Always talk to your doctor before you take any new medicine, including over-the-counter remedies, prescription drugs, vitamins, and herbs.

What causes end-stage renal disease?

Diabetes and high blood pressure are the most common causes.

Other things that can lead to end-stage renal disease include kidney diseases and infections. Long-term use of certain medicines can also damage the kidneys.

For some people, a narrowed or blocked renal artery or a kidney problem they were born with can lead to end-stage renal disease.

What other health problems can happen with end-stage renal disease?

As end-stage renal disease gets worse, it can cause:

  • Nausea, vomiting, loss of appetite, and weight loss.
  • Mental changes. These may include sleepiness, trouble thinking clearly, agitation, psychosis, seizures, and coma.
  • Bleeding problems, such as sudden or heavy bleeding from a very minor injury.
  • Heart problems, such as an irregular heartbeat and increased pressure on the heart.
  • Shortness of breath from fluid buildup in the space between the lungs and the chest wall (pleural effusion).

What is end-stage renal disease?

End-stage renal disease means that your kidneys may no longer be able to keep you alive. When your kidneys get to the point where they can no longer remove waste, you may need dialysis or a new kidney. When you understand your options, you can make the choice that's best for you.

End-stage renal disease affects your whole body. It can cause serious heart, bone, lung, blood, and brain problems.

Diet for end-stage renal disease (dialysis): Overview

You need to change your diet when you are on dialysis for end-stage renal disease (kidney failure). You will need more protein than you did before you started dialysis. You may need to limit salt and fluids. You also may need to limit minerals such as potassium and phosphorus. A diet for end-stage renal disease takes planning. A dietitian who specializes in kidney disease can help you plan meals that meet your needs.

Your nutrition needs depend on the type of dialysis you get. Talk with your doctor or dietitian to make sure your diet is right for your condition. Do not change your diet without talking to your doctor or dietitian.

End-stage renal disease: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or worse nausea and vomiting.
  • You have much less urine than normal, or you have no urine.
  • You are feeling confused or cannot think clearly.
  • You have new or more blood in your urine.
  • You have new swelling.
  • You are dizzy or lightheaded, or feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

When you decide not to treat chronic kidney disease: Overview

Chronic kidney disease means that your kidneys can no longer do their jobs well. They can't remove waste from your blood. And they aren't able to balance your body's fluids and chemicals. When the kidneys fail, many people choose dialysis or a kidney transplant. These treatments can help them live better and longer. But other people decide that they do not want these treatments.

In some cases, other health problems mean you wouldn't do well with dialysis or a kidney transplant. You may also decide that you are tired of treatments and you just want to be comfortable.

You have the right to choose what is best for you. If you decide you don't want dialysis or a transplant, you can still work with your doctor to take medicine to control symptoms.

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