When your doctor told you that you have Stage IV Chronic Kidney Disease, you must have felt a great sense of fear and shock. You may have thought, 'My life is over now.' But there is really no reason to be so discouraged. This is a serious condition, but with the right treatment, diet, and lifestyle, you can live a long and happy life. So, let's talk about everything clearly and simply today.
First, let's look at the stages of kidney disease.
There are five main stages of Chronic Kidney Disease (CKD). Think of it like a staircase.
- Early stages (1 and 2): During this stage, the kidneys may have suffered some damage, but they are still functioning well. Most often, there are no major symptoms during this stage.
- Stage 3: By now, about half of the kidneys have lost their function. This is when other health problems related to kidney failure (e.g., high blood pressure, anemia) begin to emerge.
- Stage 4: This is where the damage to the kidneys becomes severe . At this stage, your doctor will give you an intensive treatment plan to preserve whatever little function your kidneys have left.
- Stage 5: This is the final stage. Here the kidneys have almost completely failed. Dialysis or a kidney transplant is absolutely necessary to survive.
Let's understand exactly what this fourth stage (Stage IV) is.
Chronic kidney disease (CKD) occurs when the kidneys are damaged by a physical injury or, more commonly, other medical conditions such as diabetes and high blood pressure. Damaged kidneys are unable to filter blood properly.
Simply put, the kidneys are like a factory in our body. Here are some of the main jobs they do:
- Maintaining a balance of body fluids
- Regulating our hormones
- Controlling blood pressure
- Keeping bones healthy
- Producing red blood cells needed by the body
In the fourth stage, the kidneys are no longer able to do this job properly. Therefore, the risk of the following complications increases. To avoid these, you need to be very careful about your diet and lifestyle.
- Heart and blood vessel problems
- Anemia, which means a decrease in blood volume in the body
- Bone problems
- Uncontrolled high blood pressure
- Excessive fatigue and lack of energy due to lack of proper nutrition
Kidney Failure and Treatment
By stage four, the kidneys are at a very low level of function. There is a measure of the kidneys' ability to function, which we call the Glomerular Filtration Rate (GFR) . If this GFR value drops below 15%, we call that condition 'Kidney Failure'.
Although chronic kidney disease cannot be completely cured, there are very effective treatments that can save your life and keep you healthy. Don't worry, your doctor will choose the treatment that is right for you.
There are several main treatment methods. Let's take a look at them.
| Treatment method | Simply put... |
|---|---|
| Kidney Transplant | A surgical procedure to transplant a healthy kidney (from a living or deceased donor) into the body. Usually, the new kidney starts working after the surgery. However, you will still need to take medication for the rest of your life. |
| Hemodialysis (HD) | Your blood is sent to a machine that works like an artificial kidney, removes waste products and extra fluid from it, and then the cleaned blood is returned to your body. This can be done in a hospital or at home. |
| Peritoneal Dialysis (PD) | This is done at home. A special fluid is sent into the stomach through a surgically placed tube (catheter). After a few hours, the fluid is removed along with the waste, and new fluid is inserted. This needs to be done daily. |
How to do hemodialysis
To perform hemodialysis, we need to develop a system that can easily remove blood from the body and return it to the body. There are 3 main methods for this.
- Fistula: This is the best and most commonly used method. The doctor performs a small operation to connect an artery and a vein in your arm. This makes the vein stronger and easier to insert a needle and draw blood.
- Graft: If your blood vessels are weak and a fistula cannot be created, a small artificial tube is inserted between an artery and a vein to connect them.
- Catheter: If dialysis is needed urgently or for a short period of time, a large tube is inserted into a large vein in the neck or chest. One end of this tube is outside the body.
How to preserve the remaining function of the kidneys?
To prevent further damage to your kidneys, it is extremely important to properly control other diseases that are causing them.
High Blood Pressure
When blood pressure increases, the blood vessels thicken and narrow. Then the heart has to work harder to pump blood. If this is not controlled, a stroke or heart attack can occur. Therefore, it is essential to take the blood pressure medication prescribed by the doctor on time.
Diabetes and High Cholesterol
When sugar and cholesterol are out of control, fat can build up in the blood vessels, causing blood clots, and increasing the risk of heart attack or stroke. Talk to your doctor about the best diet plan for you. You may need to cut down on foods high in sugar and fat. If necessary, ask for a referral to see a dietitian.
Anemia
When the body has fewer red blood cells, there are not enough cells to carry oxygen. Then the heart has to work harder. This can lead to heart failure. For this, the doctor will prescribe you things like iron pills.
Bone and mineral related diseases
When the kidneys fail, calcium is released from the bones and enters the blood. When calcium in the blood increases, the blood vessels can become hard and narrow. The doctor may advise taking supplements such as vitamin D for this.
If you manage all of this properly, you can reduce the pressure on your kidneys and preserve their remaining function for as long as possible.
Take-Home Message
- Although stage 4 kidney disease is a serious condition, you can live well with the right treatment and lifestyle. Stay strong.
- Follow your doctor's instructions exactly, especially regarding medication and diet. Don't skip any medication or increase or decrease your dose.
- Talk openly with your doctor about your treatment options (hemodialysis, kidney transplant) and choose what is best for you.
- Controlling blood pressure, diabetes, and cholesterol levels is the best thing you can do to protect your kidneys.
- If symptoms such as extreme fatigue, shortness of breath, and swelling in the legs increase, do not ignore them and see your doctor immediately.
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