Stage 5 of Chronic Kidney Disease

A person with stage 5 chronic kidney disease has end stage renal disease (ESRD) with a glomerular filtration rate (GFR) of 15 ml/min or less. At this advanced stage of kidney disease, the kidneys have lost nearly all their ability to do their job effectively, and eventually dialysis or a kidney transplant is needed to live.

Symptoms of stage 5 CKD

Symptoms that can occur in stage 5 CKD include:

  • Itching
  • Nausea or vomiting
  • Swelling, especially around the eyes and ankles
  • Tingling in hands or feet
  • Loss of appetite
  • Being tired
  • Muscle cramps

If you are diagnosed with stage 5 CKD, you will need to see a nephrologist immediately. This is a doctor who is trained in kidney disease, kidney dialysis and transplant. The doctor will help you decide which treatment is best for you — hemodialysis, peritoneal dialysis (PD) or kidney transplant — and will recommend an access for dialysis. Your nephrologist will develop your overall care plan and manage your healthcare team.

Dialysis treatments for people with stage 5 CKD

There are two types of dialysis treatments options for people with stage 5 kidney disease.

  1. In hemodialysis, a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean your blood. To get your blood into the dialyzer, the doctor needs to make an access, or entrance, into your blood vessels. This is done with minor surgery, usually to your arm.
  2. A soft plastic tube (catheter) is placed in your belly by surgery. A sterile cleansing fluid is put into your belly through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.

Kidney transplant is another treatment option

If you wish to have a kidney transplant, tell your nephrologist. Your nephrologist will explain the process of how to get on a waiting list for a cadaverous kidney or how to find a living donor. Kidney transplantation is considered the treatment of choice for many people with severe chronic kidney disease because quality of life and survival (life expectancy) are often better than in people who are treated with dialysis. However, there is a shortage of organs available for donation. Many people who are candidates for kidney transplantation are put on a transplant waiting list and require dialysis until a kidney is available.

Changes in the diet for people with stage 5 CKD

Once you begin dialysis, you will need to make changes in what you eat and drink. Your diet is a big part of your treatment, so you will be working with a dietitian who will coach you on how you should eat. Depending on the dialysis treatment you choose and your lab test results, your dietitian will help create a meal plan based on your individual requirements to keep you feeling your best. Your dietitian will explain what foods are restricted and which ones are recommended on the renal diet.

A healthy diet for stage 5 CKD may recommend:

  • Including grains, fruits and vegetables, but limiting or avoiding whole grains and certain fruits and vegetables that are high in phosphorus or potassium
  • A diet that is low in saturated fat and cholesterol and moderate in total fats, especially if cholesterol is high or if you have diabetes or heart disease
  • Limiting intake of refined and processed foods high in sodium and prepare foods with less salt or high-sodium ingredients
  • Decreasing calcium intake if necessary
  • Limiting fluid intake
  • Increasing protein intake to the level determined by the dietitian’s assessment of individual needs and to replace losses in the dialysis treatment

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