It is difficult to say how long can you live with stage 5 kidney disease because it is dependent on the following factors:
- Whether you are on dialysis
- The frequency and hours you are taking dialysis
- Diabetes and heart disease or other comorbid conditions
- Salt intake
- Preserved kidney function
- Presence of inflammation in the body
- Blood hemoglobin level
- Sleep disturbances
- Weight loss
- Fatigue or exhaustion
- Muscle weakness
- Poor compliance with dialysis sessions and dietary restrictions
- Sedentary lifestyle
Dialysis is needed when you develop end-stage kidney failure, which is usually when you have lost 85%-90% function of the kidneys. This is termed end-stage renal disease. Your kidneys have a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m2 at this stage.
From anecdotal reports and studies, the average life span of patients with stage 5 kidney disease ranges from 5-10 years. However, patients have lived for up to 20 years with the help of dialysis.
What are the signs and symptoms of stage 5 kidney disease?
Stage 5 chronic kidney disease presents with important physical and psychological symptoms in the last months of life. These symptoms may be similar to or greater than those in patients with advanced cancer.
In end-stage renal disease (ESRD), the function of the kidney to effectively filter wastes fluids, electrolytes, and minerals out of the blood reduces. These waste products eventually accumulate within the body. This can cause a wide range of signs and symptoms.
Normal kidneys carry out important bodily functions, such as controlling blood pressure, strengthening bones, and making new red blood cells. These functions are also hampered in ESRD.
You may experience most or all the following signs and symptoms:
- Swelling of the feet and ankles
- Nausea and vomiting
- Reduced appetite or unintended weight loss
- Reduced urination
- Sleeping disorders
- Muscle cramps and exhaustion
- Pain, stiffness, and swelling in the joints
- Weakness or numbness
- Bleeding through the nose and easy bruising
- A loss of sense of taste
- Confusion, memory problems, or difficulty concentrating
These symptoms and signs may vary in severity and occur either all or at least most of the time.
How do doctors diagnose stage 5 kidney disease?
Your healthcare provider may ask about your family's and your medical history to diagnose your condition.
You may have to undergo the following physical and neurological exams along with other tests:
- Blood tests: Blood creatinine and urea are wastes that accumulate in the blood in stage 5 kidney disease.
- Urine tests: To estimate the level of the protein, albumin, in your urine.
- Imaging tests: Ultrasound, magnetic resonance imaging, or computed tomography scan to assess the kidneys and detect any abnormalities.
- Glomerular filtration rate (GFR): It is a measure to estimate the level of kidney function. It is calculated by the lab specialist based on a combination of several factors that include creatinine levels, age, weight, height, etc. GFR test is usually done after the above tests show abnormalities. Doctors usually confirm kidney damage on encountering low levels of GFR.
Your doctor would also like to know if you have diabetes or heart problems. Hence, they may ask for the following tests:
- Blood sugar test
- Urine sugar test
What is the treatment for stage 5 kidney disease?
There is no cure for stage 5 kidney disease. Treatment can just help control the signs and symptoms.
A kidney specialist (nephrologist) will prescribe you medications that will aim to do the following:
- Lowering blood pressure to less than 130/80 mmHg
- Halting the worsening of the kidney disease
- Reducing the risks of getting heart disease
Advanced stages of kidney disease usually require lifetime dialysis or a kidney transplant to increase survival by a few years.
Along with the right medications, certain lifestyle changes are a must. The dietary modification depends on the stage of kidney disease you are at. For example, higher stages of chronic kidney disease necessitate you to lower your daily dietary intake of protein, phosphorus, and potassium. A certified nutritionist can recommend the most appropriate diet plan for you.
Here are some commonly recommended lifestyle steps:
What are the complications of stage 5 kidney disease?
These are the complications of stage 5 kidney disease:
- Excessive fluid retention in many parts of the body
- Anemia (low blood hemoglobin level)
- Hyperkalemia (high blood potassium levels that can damage the heart)
- Cardiovascular disease (heart and blood vessel disease)
- Lower sex drive
- Erectile dysfunction
- Osteomalacia (weakening of bones)
- Damage to the central nervous system
- Weak immune system
Without either dialysis or a transplant, kidney failure progresses and can even turn life-threatening quickly. Supportive care may help you manage your symptoms and help you improve your quality of life.
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Henrich WL, Burkart JM. "Patient survival and maintenance dialysis." UpToDate. Oct. 5, 2020. <https://www.uptodate.com/contents/patient-survival-and-maintenance-dialysis>.
Murtagh FE, Addington-Hall J, Edmonds P, et al. "Symptoms in the month before death for stage 5 chronic kidney disease patients managed without dialysis." J Pain Symptom Manage 40.3 Sept. 2010: 342-52. <https://pubmed.ncbi.nlm.nih.gov/20580200/>.
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