Is there swelling in your arms and legs? Are you feeling fatigued more often, and there’s some disparity in your urination - is it too less or too much? Or, do you suffer from consistent back pain and have been totally ignoring it?

Well, if you’re experiencing any of these signs or all of them, you must immediately consult your doctor. Because you’re likely to have Stage 4 kidney disease. That’s what the symptoms are suggesting.

Are you aware of what Stage 4 kidney disease is? What are the symptoms experienced? Or how you’re supposed to manage it?

We’ll help you figure out all of it in this article.

Stage 4 kidney disease or Chronic Kidney Disease is when your kidneys lose their ability to filter the blood. It is the last stage before your kidney failure happens.

Sounds alarming? Well, there are ways to manage it. All you need to know is how and where to begin and how to go through the journey, seamlessly.

In this blog, we will discuss Stage 4 kidney disease, its treatment and the care needed for this stage.

Chronic Kidney Disease and its Stages

Before getting into the management and care part, let us first understand in detail what Stage 4 kidney disease is.

You might already know that kidneys are one of the most important organs in your body. They filter your blood and remove toxins, wastes, and excess fluids from your body.

When your kidney loses its ability to function gradually, it is known as Chronic Kidney Disease.

Its ability to filter the blood and remove waste materials and other fluids from the blood gradually decreases.

As a result fluids, electrolytes, waste materials, and toxins accumulate in your body.

Some of the symptoms of chronic kidney diseases are nausea, vomiting, loss of appetite, sleeplessness, fatigue, weakness, chest pain, high blood pressure, dry and itchy skin, swelling of feet and ankles, muscle cramps, breathing trouble, etc.

Chronic kidney disease has 5 stages. This division is based on Glomerular Filtration Rate (GFR). This mathematical formula involves a person’s age, gender,and their serum creatinine level.

Following table will give you an idea about stages of kidney disease and kidney functioning in those stages.

Stage 4 Kidney Disease - What is it?

In this stage, your kidneys are pretty much damaged.

Your Glomerular Filtration Rate is much lower, ranging between 15 to 29 mL/min. And your kidneys can function only between 15 to 29%

As a result of these declining kidney functions, you may develop a condition called Uremia. This is because your kidney does not perform its filtration function well, and as a result waste products get accumulated in your body.

It can lead to other complications such as heart disease and other cardiovascular disease, bone disease, anaemia, high blood pressure, high potassium, high phosphorus, metabolic acidosis (acid buildup in your body) etc.

What are the symptoms of Stage 4 kidney disease? Here they are:

• Fatigue

• Feeling weak and tired all the time

• Urination is not normal (ie, either it is high or lower than normal; foamy; red, tea coloured, brown or dark orange in colour)

• Swelling in your Arms and Legs or Edema due to fluid buildup

• Pain in your Lower Back

• Loss of Appetite

• Muscle Cramps

• Restless Legs

• Nausea

• Vomiting

• Breathing trouble

• Metallic taste in the mouth

• Your breath smells bad because of urea buildup

• Difficulty in concentrating

• Numbness/Tingling in the toes or fingers

Causes of Stage 4 Kidney Disease

To reach Stage 4, it takes quite a bit of time and several reasons. You must know them so that you can be alert from beforehand and prevent this progression

• Diabetes - When you have diabetes, your body does not produce enough insulin to remove glucose from the blood. This glucose travels around your body and damages your blood vessels, other organs and eventually the filters in your kidneys.

• Hypertension - Because of hypertension or high blood pressure, veins and arteries of your kidneys get damaged. This affects their filtering abilities.

• Glomerulonephritis - a range of inflammatory kidney conditions of the tiny blood vessels in the kidneys, known as glomeruli.

• Toxicity from drugs

• Over exposure to heavy metals

• Systemic disease or diseases which affect your whole body instead of a particular organ, eg, Lupus

• Rare Genetic Disorders

• Renal Artery Stenosis where the arteries of your kidneys get narrowed

• Sometimes immunoglobulin A antibodies build up in different parts of your kidneys and blood vessels. Such conditions can lead to stage 4 kidney disease

Treatment for Stage 4 Kidney Disease

If your doctor diagnoses your kidney disease only at this stage, he will definitely refer you to a Nephrologist or a Kidney Specialist.

They obviously cannot bring your kidneys back into their normal condition, but can certainly help you in slowing down any further progression. They can also help you in dealing with other health conditions which are caused by kidney disease.

Since the next stage is kidney failure, it is important for you to take necessary treatment and care.

Some of the medicines that your doctor might prescribe are the following :

• Medicines to manage your high blood pressure and blood sugar levels.

• Calcium Supplements and Vitamin D to reduce the risk of bone disease.

• Diuretics which can prevent fluid buildup and thus, swelling of your limbs.

• Iron supplements to reduce Anaemia.

They will also recommend you to stop taking medicines which could potentially damage your kidneys.

A specialist can also determine whether you are close to kidney failure.

In that case, they will recommend either of the following :

Dialysis

Dialysis are of 2 types :

In Hemodialysis, your blood filters through a machine that functions as an artificial kidney. Once your blood filters a little at a time, it returns to your body.

You can undergo these processes either at your home or a dialysis centre.

Peritoneal dialysis is done at home, on a daily basis. A catheter is inserted into your abdomen. A cleansing solution is inserted through the tube. Solution can be drained in a few hours and the tube can be refilled with fresh solution for the next cycle of cleaning.

Kidney Transplant

You will get a Kidney from a donor who is already dead, or from a living donor. Even after Kidney transplant, you need to strictly follow the doctor’s instructions and medications.

Steps to Slow Down the Kidney Damage

• Visit your Nephrologist once every 3 months.

• Follow a healthy diet which includes fruits and vegetables, whole grains, lean meats, fish.

• Engage in regular physical activities after discussing with your doctor.

• Avoid alcohol, drugs, and smoking or tobacco.

• Avoid exposure to heavy metals.

• Maintain a normal blood pressure level and normal blood sugar level.