Why is it so important to detect kidney disease in its early stages, even if it’s rather hard to diagnose? Because when you reach Stage 4, you are likely past the point of living without serious medical intervention or even a transplant. And by the time you arrive at Stage 5, you have virtually no other option. There is nothing else to do but plan for a transplant.
In Stage 5, the kidneys have only about 15% of function left – or less. At this point, if left on their own, they would be completely unable to keep the patient alive. Dialysis now becomes very important to filter the blood of impurities the kidneys can’t remove.
Most symptoms are the same as for Stage 4 or earlier, but multiplied considerably. The person experiences the same tendency to hypertension (high blood pressure) because of the inability to expel fluids. And because the heart is working that much harder as a result, the person may suffer pericarditis , which is an inflammation of the lining around that organ. There would now be very high levels of creatinine and urea, which the kidneys can’t filter out. And susceptibility to infections would also increase.
The inability to absorb calcium or for the kidneys to produce the chemical that stimulates production of red blood cells worsens. And therefore the reduction in bone density and the tendency toward anemia would continue to be a problem. Added to these symptoms would come others that might seem comparatively “minor,” but which could be aggravating. These include difficulty sleeping, shortness of breath, increased itching, or frequent vomiting.
Certain treatments can attempt to bring down blood pressure or reduce anemia, while dietary adjustments may allow more absorption of calcium. But now with such reduced filtering capacity, dialysis is usually the only way to cleanse the bloodstream of impurities. Some patients can survive for a long time with dialysis treatments, though the most common form of dialysis takes several hours, three days a week, and therefore restricts their lifestyle. But for others, dialysis may lose its effectiveness relatively quickly. And the best hope in both cases is for a kidney transplant.
There are usually signs of kidney disease well before things reach Stage 5. To maintain good health and never allow themselves to arrive at this stage, the wisest course for everyone is to have yearly, thorough checkups with detailed blood work, and to investigate even the most nebulous symptoms that might indicate kidney disease.