Stage 4 of Chronic Kidney Disease | Complete Overview

Stage 4 of Chronic Kidney Disease

Stage 4 kidney disease occurs when your estimated glomerular filtration rate (eGFR) falls between 15–29, indicating a severe loss of kidney function. At this stage of chronic kidney disease (CKD), it’s important to manage your health as best you can to preserve kidney function and start planning ahead for potential treatments like a kidney transplant or dialysis. Seeing a kidney doctor (nephrologist) can help you learn about and compare options, so you can make treatment choices that are right for you.

As kidney function declines, waste products build up in the blood causing a condition known as uremia. In stage 4, a person is likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases.


Symptoms of stage 4 kidney disease

Many people do not experience symptoms of kidney disease until the later stages when kidney damage has occurred. Possible stage 4 kidney disease symptoms and signs include:

  • Anemia
  • Decreased appetite
  • Bone disease
  • Abnormal blood levels of phosphorous, calcium, or vitamin D

Steps to take at stage 4 kidney disease

  • Follow a kidney-friendly diet—Learning how to eat well with kidney disease is key to keeping your kidneys working longer. If you’re not already working with a dietitian, ask your doctor or nephrologist for a referral. A dietitian can help you choose kidney-friendly foods and beverages.
  • See a nephrologist—If you’re not already seeing a kidney doctor (nephrologist), ask your primary care doctor for a referral. A nephrologist specializes in kidney disease and is the most qualified to guide your CKD treatment. He or she will examine your lab tests, talk to you about managing your kidney health, and help you determine which treatment best fits your lifestyle. You’ll continue to see your regular doctor to monitor your overall health and any other existing conditions.
  • Start building your support network—Reach out to people who care about you and can encourage you. Your family, friends, and doctor will want to support you and help you stay motivated.
  • Learn about your potential treatment options—Now is a good time to start learning all you can about your potential treatment options in case of kidney failure. Ask your doctor about peritoneal dialysis, in-center or home hemodialysis, and a kidney transplant. It’s important to find a treatment option that best fits your lifestyle.
  • Choose a dialysis access type—If you’re considering dialysis, talk to your doctor about your options for dialysis access and how to get your access placed.

Questions to ask your doctor about stage 4 kidney disease

  • Which treatment option may be right for me?
    There are several treatment options for kidney failure to consider, including a kidney transplant or home dialysis. Ask your doctor which option may best fit your lifestyle.
    • Kidney transplant
      The closest thing to natural kidney function and considered the most effective option for ESRD. With a kidney transplant you receive a new, healthy kidney from a living or deceased donor.
    • Dialysis
      This life-extending treatment option helps remove unwanted toxins, waste products, and excess fluids from the body by filtering your blood.
  • Am I eligible for a kidney transplant?
    Talk to your doctor about whether or not kidney transplant surgery is right for you. A successful kidney transplant is the closest to natural kidney function and considered the most effective treatment for kidney failure.
  • What should I know about dialysis access types?
    Your access is the location on your body where dialysis equipment can be connected to your bloodstream (for hemodialysis) or peritoneum (for peritoneal dialysis). Choosing your dialysis access early may give you more placement options.

How to follow a kidney-friendly diet with stage 4 kidney disease?

One of the best ways to keep your kidneys working longer is to follow a kidney-friendly diet. A healthy stage 4 kidney disease diet may involve limiting or monitoring your intake of:

  • Protein
  • Potassium
  • Phosphorus
  • Sodium
  • Fluids

Your level of kidney function and individual lab tests will determine your dietary needs. Talk to a renal dietitian about what foods you should eat. He or she will help you plan kidney-friendly meals that you’ll enjoy eating.

Stage 4 kidney disease life expectancy

Stage 4 kidney disease life expectancy depends on a number of factors, including your age at the time of diagnosis, your other medical conditions, and your individual treatment plan. While there’s no cure for kidney disease and any kidney damage that has occurred can’t be reversed, you can take action now to help preserve kidney function and slow the progression of CKD. Looking after your health and eating a kidney-friendly diet can also help you feel your best.

What are the complications of stage 4 kidney disease?

Stage 4 kidney disease can cause complications to your overall health.

Common complications of kidney disease include:

  • high blood pressure (hypertension)
  • anemia (low red blood cell count)
  • mineral and bone problems
  • heart and blood vessel problems
  • poor nutritional health

Experts recommend a person with stage 4 or 5 kidney disease avoid pregnancy. This is due to the high risk of complications associated with the condition.

Stage 4 kidney disease lifestyle changes

There are other lifestyle changes to help prevent further damage to your kidneys. These include:

  • Not smoking, if you smoke: Smoking damages blood vessels and arteries. It increases the risk of clotting, heart attack, and stroke. If you have trouble quitting, talk with your healthcare professional about smoking cessation programs.
  • Exercise: Aim to exercise 30 minutes daily, at least five days a week.
  • Take all prescribed medications as directed: In addition to taking all prescribed medications, ask your healthcare professional before adding over-the-counter (OTC) medications or supplements.
  • See your healthcare professional regularly: Be sure to report and discuss any new and worsening symptoms with your healthcare professional.

Can your kidneys recover from stage 4 kidney failure?

Once your kidneys become damaged, they cannot get repaired. Doctors can replace the kidney with a donor’s kidney if one is available, but they cannot use medications or other methods to fix the kidney.

What is ICD 10 Code for Stage 4 Chronic Kidney disorder?

The International Classification of Diseases (ICD) is a system used by healthcare professionals to classify and code diseases and medical conditions. Chronic kidney disease (CKD) is a progressive condition that affects the kidneys’ ability to filter waste and fluids from the blood.

The ICD-10 code for stage 4 chronic kidney disease is N18.4. This code falls under the category of “chronic kidney disease, stage 4 (severe),” which is further classified as a subcategory of “chronic kidney disease (CKD).”

The N18.4 code is used to indicate that a patient has a severe stage of chronic kidney disease, with a glomerular filtration rate (GFR) of 15-29 ml/min. This means that the kidneys are functioning at a significantly reduced capacity, and the patient may require medical interventions such as dialysis or a kidney transplant.

It is important to note that the ICD-10 code N18.4 only provides a general classification for the stage of CKD. The specific cause and management of the condition will vary from patient to patient and require additional codes to fully describe the patient’s medical condition.

Does stage 4 Kidney disease qualify for disability?

In the United States, individuals with stage 4 kidney disease may qualify for disability benefits if their condition meets the requirements of the Social Security Administration’s (SSA) Listing of Impairments or if their condition prevents them from performing substantial gainful activity (SGA). The SSA considers the severity of the individual’s symptoms, the effectiveness of their treatments, and the limitations on their ability to work when determining disability eligibility. It is important to consult with a qualified disability attorney or representative to determine your eligibility and to assist you with the application process.

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