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:
Loss of appetite
Nausea or vomiting
Headaches
Being tired
Being unable to concentrate
Itching
Making little or no urine
Swelling, especially around the eyes and ankles
Muscle cramps
Tingling in hands or feet
Changes in skin color
Increased skin pigmentation
Because the kidneys are no longer able to remove waste and fluids from
the body, toxins build up in the blood, causing an overall ill feeling.
Kidneys also have other functions they are no longer able to perform such
as regulating blood pressure, producing the hormone that helps make red
blood cells and activating vitamin D for healthy bones.
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
Most people report feeling much better once they begin dialysis. As the
toxins are removed from the blood medicines replace the functions the
kidneys can no longer perform, they find they can enjoy a good quality of
life. There are two types of dialysis treatments for people with stage 5
kidney disease.
1. Hemodialysis: This treatment that can be done in a center or in a
patient’s home with assistance from a care partner. A dialysis machine
removes a small amount of a patient’s blood through a man-made
membrane called a dialyzer, or artificial kidney, to clean out toxins that
the kidneys can no longer remove. The filtered blood is then returned to
the body.
2. Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free
treatment and a care partner is not required to to help assist during
treatment. PD can be performed at home or at work.
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.
When at stage 5 CKD, either dialysis or a kidney transplant is necessary to
continue living.
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
Aiming for a healthy weight by consuming adequate calories and
including physical activity each day within your ability
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
Taking special renal vitamins high in water soluble B vitamins and
limited to 100 mg of vitamin C
Vitamin D and iron tailored to individual requirements
Find a doctor when you have stage 5 CKD
When a person learns he or she has stage 5 kidney disease, working with a
nephrologist is necessary to ensure they have the right tools to treat their
condition.
