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Chronic kidney disease (CKD) occurs when the kidneys become damaged and can no longer adequately filter blood. The kidneys are responsible for filtering extra water and waste out of the blood to produce urine. When the kidneys don’t function properly, waste can build up in the body, causing various symptoms and problems.
Kidney disease can worsen over time and lead to kidney failure. Early diagnosis can help prevent further damage to the kidneys.
Chronic kidney disease is a slow, progressive disease diagnosed in stages. Stages 1 and 2 indicate mild damage to the kidneys, while stages 3, 4, and 5 reflect more serious progression that affects prognosis and life expectancy.
In this article, you will learn more about stages 3, 4, and 5 of CKD, life expectancy at each stage, and how to cope with the disease.
The stages of chronic kidney disease range from mild to severe. In the early stages (1 and 2), damage to the kidneys is mild. The kidneys still work fairly well, and symptoms may not occur. The only indication of kidney damage may be in certain blood or urine tests.
The later stages of CKD occur when damage to the kidneys becomes more apparent. Symptoms often appear in these stages.
Stage 3 kidney disease is separated into two sub-stages: stage 3a and stage 3b. These substages are based on an eGFR blood test which measures how well the kidneys filter waste.
An eGFR between 45 and 59 indicates stage 3a. Kidney damage in this stage is mild to moderate. Symptoms such as swelling in the hands and feet and feeling weak and tired may appear.
An eGFR between 30 and 44 indicates stage 3b. Kidney damage is moderate to severe, and symptoms may progress. Other health problems such as high blood pressure and bone disease can also occur.
In one study, about half of people with stage 3 did not progress to stage 4 or 5. Treatment and healthy lifestyle changes to protect the kidneys can slow the progression of CKD.
Stage 4 indicates severe kidney damage with an eGFR of 15-29. Symptoms can include swelling in the arms and legs, muscle cramps, nausea, vomiting, and loss of appetite.
Other health problems can develop because of the buildup of waste in the body. These include:
Stage 4 is the last stage before kidney failure. Treatment includes blood pressure and diabetes medicines, diuretics (water pills), iron supplements to help with anemia, and supplements like calcium and vitamin D.
In some cases, dialysis, a treatment to help the body filter the blood, may become necessary.
Stage 5, also known as end-stage renal disease, is indicated by an eGFR of less than 15. Damage to the kidneys is severe. The kidneys have failed. The symptoms and concurrent health issues such as high blood pressure and anemia from stage 4 can all occur in stage 5 as well.
In this stage, you will need to see a nephrologist, or kidney doctor, to develop a treatment plan and monitor your kidney health.
Treatment options in this stage include dialysis or kidney transplant, along with blood pressure medications, diabetes medications, and other medications to treat symptoms.
Life expectancy with CKD depends on the person's age and the stage at which diagnosis occurs. Having more kidney damage at an earlier age can reduce life expectancy more than being diagnosed later in life with less kidney damage.
Life expectancy for stage 3 kidney disease is dependent on the age of diagnosis. One study found that the life expectancy for men and women diagnosed with stage 3a at the age of 40 was a little under 12 years less than the average U.S. life expectancy.
On the other hand, the same study found that being diagnosed with stage 3a at age 60 resulted in about a six-year decrease in life expectancy compared to average U.S. life expectancy.
Stage 4 kidney disease is associated with greater damage to the kidneys. At this stage, the disease has progressed quite far.
The life expectancy for someone diagnosed with stage 4 at any age is significantly lower than the average life expectancy. One study found that the life expectancy for someone age 70 who enters stage 4 kidney disease is about four years.
As with any such figures, there are many factors, such as newer treatments, that might not be reflected in past studies.
Stage 5 kidney disease, or end-stage renal disease, carries a much lower life expectancy than all other stages. At this stage, the kidneys have failed.
The damage to the kidneys cannot be undone. While dialysis and kidney transplant are options in this stage that can prolong life, life expectancy is fairly low.
Living well with chronic kidney disease is possible. Knowing the signs and symptoms, understanding the causes, seeking early diagnosis, and following a treatment plan can all help you live a longer, healthier life with CKD.
The early stages of CKD may not have symptoms. Though there may be damage to the kidneys the damage is not enough to cause symptoms. As CKD progresses, symptoms develop.
Symptoms include but aren’t limited to:
Diabetes and high blood pressure are the two most common causes of chronic kidney disease. In diabetes, high blood sugar can damage the filters in the kidneys, making them unable to function the way they should.
High blood pressure can cause damage to the blood vessels in the kidneys and affect their ability to function.
Other causes of CKD include:
Diagnosis of chronic kidney disease is important because the earlier the diagnosis the earlier treatment can begin to help protect the kidneys.
Those at higher risk for developing chronic kidney disease should talk to their healthcare provider about when to test for kidney disease. Having diabetes, high blood pressure, heart disease, or a family history of kidney failure can all put you at a higher risk for developing kidney disease.
Early chronic kidney disease often does not have symptoms. Diagnosing the disease requires medical tests. These tests include the eGFR blood test to check kidney function and urine tests that check for protein.
The goal of treating and managing chronic kidney disease is to limit or prevent further damage to the kidneys. Preventing further damage to the kidneys can slow progression to later stages of CKD which in turn can improve life expectancy.
Steps taken to manage CKD can also improve overall health. These include:
Dialysis and kidney transplant are used to treat end-stage kidney disease. Dialysis allows people with end-stage kidney disease to prolong life by years or even decades. Dialysis is also an option for those who are waiting for a kidney transplant.
A kidney transplant is one of the best options for end-stage renal disease. Long-term survival and quality of life increase with a transplant. However, a transplant does carry risks in the short term due to the possibility of infection and organ rejection.
Life expectancy with chronic kidney disease depends on the age at which you enter each stage. There are five stages of CKD, with stages 3, 4, and 5 being the most severe.
Seeking early diagnosis and treatment for CKD can improve life expectancy. Treatment options are available. Dialysis and kidney transplant can lead to a longer and better quality of life.
A diagnosis of chronic kidney disease can be scary and make you wonder about life expectancy. Taking a proactive approach to managing your health can help give you a sense of control and peace of mind.
Regularly working with your healthcare provider to develop a treatment plan to protect your kidneys from further damage and prevent other complications can help prolong life.
Chronic kidney disease’s effect on life expectancy depends on the amount of damage to the kidneys. However, it decreases life expectancy at every age and stage. Preventing further damage to the kidneys as well as preventing other conditions (such as heart disease) are critical to having the best life expectancy.
Chronic kidney disease can progress to end-stage renal disease, which is terminal without ongoing dialysis or a kidney transplant. However, progression is not inevitable.
With proper treatment and healthy lifestyle changes, it is possible to live a long life with CKD.
Chronic kidney disease cannot be cured. Damage to the kidneys is permanent which is why preventing further damage is important.
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National Institute of Diabetes and Digestive and Kidney Diseases. What is chronic kidney disease?
American Kidney Fund. Stages of kidney disease.
MedlinePlus. Glomerular filtration rate (Gfr) test.
Baek SD, Baek CH, Kim JS, Kim SM, Kim JH, Kim SB. Does stage III chronic kidney disease always progress to end-stage renal disease? A ten-year follow-up study. Scand J Urol Nephrol. 2012;46(3):232-238. doi:10.3109/00365599.2011.649045
National Institute of Diabetes and Digestive and Kidney Diseases. Managing chronic kidney disease.
American Kidney Fund. Stage 4 chronic kidney disease (CKD).
American Kidney Fund. Stage 5 chronic kidney disease (CKD).
Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017;32(2):243-248. doi:10.1007/s00467-016-3383-8
Reindl-Schwaighofer R, Kainz A, Kammer M, Dumfarth A, Oberbauer R. Survival analysis of conservative vs. dialysis treatment of elderly patients with CKD stage 5. PLoS One. 2017;12(7):e0181345. doi:10.1371/journal.pone.0181345
National Institute of Diabetes and Digestive and Kidney Diseases. Causes of chronic kidney disease.
National Institute of Diabetes and Digestive and Kidney Diseases. Chronic kidney disease tests & diagnosis.
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Dialysis in chronic kidney disease.
Kaballo MA, Canney M, O'Kelly P, Williams Y, O'Seaghdha CM, Conlon PJ. A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clin Kidney J. 2018;11(3):389-393. doi:10.1093/ckj/sfx117
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