If someone diagnosed with stage 4 CKD who will have a serious kidney damage.and look like need to dialysis or kidney transplant.In order to avoid this stage,we should learn some knowledgs about stage 4 CKD.
A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage
with a severe decrease in theglomerular filtration rate (GFR) to 15-30 ml/min.
It is likely someone with stage 4 CKD will need dialysis or a kidney transplant
in the near future.
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 ofkidney disease such as high blood pressure, anemia (a shortage
of red blood cells), bone disease,heart disease and other cardiovascular
diseases.
Symptoms that are experienced in stage 4 include:
Fatigue: Feeling tired is common for people with CKD and is often caused by
anemia.
Too much fluid: The kidneys may lose their ability to control how much fluid
stays in the body. A person may notice swelling (edema) in their lower legs,
hands or face around the eyes. With too much fluid someone, could even feel
short of breath.
Urination changes: Urine may be foamy if there is protein in it, or dark
orange, brown, tea colored or red if it contains blood. A person may urinate
more or less than normal, or get up at night to go to the bathroom.
Kidney pain: Most people with CKD do not have kidney pain, but with some
kinds of kidney problems, such as polycystic kidney disease (PKD) or infections,
they may have pain in their back where the kidneys are located.
Sleep problems: Some people have trouble falling asleep or staying asleep.
Itching, muscle cramps or restless legs can keep them awake.
Nausea: Vomiting or feeling nauseated may occur with CKD.
Taste changes: Food may not taste like it usually does, or may have a
metallic taste.
Uremic breath: As urea builds up in the blood, it may be detected in the
breathing causing bad breath.
Loss of appetite: People in this stage may not feel like eating, and some
people report having a metallic taste in their mouth or bad breath.
Difficulty in concentrating: Having trouble balancing a checkbook or focusing
on reading the newspaper can happen with CKD.
Nerve problems: Numbness or tingling in your toes or fingers is a symptom of
CKD.
At stage 4 it is necessary to see a nephrologist (a doctor who specializes in
treating kidney disease). The nephrologist examines the patient and orders lab
tests to gather information to recommend treatment.
People in stage 4 CKD will usually visit their doctor at least every three
months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels
will be done to see how well the kidneys are working. The doctor will also
monitor other conditions such as high blood pressure and diabetes. In addition
to helping the patient keep their kidneys working as long as possible, the
nephrologist will also help prepare the patient for dialysis or a kidney
transplant.
Those with stage 4 CKD who will need treatment are told about their choices,
which arehemodialysis, peritoneal dialysis (PD) or a kidney transplant. For
those who choose hemodialysis they will learn about getting a vascular access.
The vascular access allows the patient’s blood to travel to and from the
dialysis machine at a large volume and high speed so that toxins, waste and
extra fluid can be removed from the body. The AV (arteriovenous) fistula and AV
graft are created surgically and need a few months or so to mature. The
nephrologist will inform their Stage 4 patient about the procedure to have the
access placed and the advantages of having an AV fistula in place before
beginning dialysis.
Someone in stage 4 may also be referred to a dietitian. Because diet is such
an important part of treatment, the dietitian will review a person’s lab work
results and recommend a meal plan individualized for their needs. Eating a
proper diet can help preserve kidney function and overall health. For stage 4 a
dietitian will usually recommend eating a healthy diet with reduced amounts of
protein to help decrease build up of protein waste. Phosphorus may be limited to
help keep blood phosphorus or PTH normal and prevent renal bone disease.
Controlling phosphorus may also help preserve existing kidney function. Calcium
may be limited if blood levels are too high. Potassium may be restricted in
stage 4 CKD if blood levels are above normal. The dietitian will also take into
consideration if the patient has diabetes and provide tips on limiting
carbohydrates in their diet. They may also recommend a diet low in sodium for
those with high blood pressure or fluid retention. Supplementation with water
soluble vitamins may be recommended. Vitamin C may be limited to 100 mg per day
from supplements. Nutrients like Vitamin A and some minerals may not be
recommended because levels can build up in the blood as kidney function
declines. The dietitian may recommend avoiding over the counter dietary
supplements unless approved by the nephrologist. It is helpful to work with a
registered renal dietitian because as the stages of CKD change, so will the
diet.
A healthy diet for stage 4 CKD may recommend:
.Including grains, fruits and vegetables, but limiting whole grains and
certain fruits and vegetables if blood tests show phosphorus or potassium levels
are above normal.
.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.
.Limiting protein intake to the level determined by the dietitian’s assessment
of individual needs.
.Consuming the DRI for the water soluble vitamin B complex and C.
.Vitamin D and iron may be tailored to individual requirements.
.Limiting phosphorus if blood levels of phosphorus or PTH are above
normal.
.Limiting calcium if blood levels are above normal.
.Limiting potassium if blood levels are above normal.
It is recommended that people in stage 4 keep their blood pressure at a
healthy level and those with diabetes keep their glucose level under control.
Taking all the medicines as prescribed by the doctor may help prolong kidney
function.
In addition to eating right and taking prescribed medicines, exercising
regularly and notsmoking are helpful in maintaining health. Patients should talk
to their doctors about an exercise plan. Doctors can also provide tips on how to
stop smoking.
The NKF guidelines recommend starting dialysis when kidney function drops to
15% or less. By doing everything possible to help prolong kidney function and
overall health, the goal is to put off dialysis or transplant for as long as
possible.
If you would like to see a doctor who specializes in the care of kidneys,
called a nephrologist, you can use DaVita's Find a Kidney Doctor tool to locate
a nephrologist in your area.
Treatment
Traditional Chinese Therapy could ease this symptoms natually,There is a therapy named Blood Pollution Therapy.The polluted blood flowed in patients’ body is the primary cause of kidney
diseases.
Blood Pollution Therapy is the latest treatment for kidney disease,
which can treat kidney problems from the polluted blood instead of the
kidneys.
If you want to know more about this therapy,
Contact me.
