The stage 4 kidney disease

stage 4 kidney disease

The American Association of Kidney Patients (AAKP) defines stage 4 kidney disease as follows: Stage 4 CKD is present when the kidneys have lost more than 90% of their ability to function and dialysis or a kidney transplant is needed. In other words, at this point, you would be diagnosed with end-stage renal disease. Stage 4 CKD, which is also known as renal failure or advanced kidney disease, is the most advanced stage of chronic kidney disease (CKD).

Basics of Kidney work

A group of people standing on a stage

To understand what stage 4 means, it helps to have a basic understanding of how the kidneys work. The kidneys are two bean-shaped organs that are located near the middle of the back, just below the rib cage. They remove excess water and waste from your blood while conserving important nutrients. As blood passes through tiny capillaries in each nephron, these specialized cells filter out excess water and waste materials in order to get rid of them from the body in the form of urine.

The symptoms of stage 4 of kidney disease


When you have stage 4 CKD, all the symptoms of earlier stages tend to get worse and new ones to appear. The following is a list of common symptoms:

Blood in your urine (hematuria):

This symptom might be caused by a medical procedure that irritates the lining of your urinary tract or it may indicate a more serious problem such as kidney damage due to diabetes. Sometimes hematuria is the first warning sign that you may develop kidney disease. Blood in the urine also may indicate bladder cancer, so it’s important to see your doctor if this symptom occurs without an apparent cause such as injury from coughing, straining during bowel movements, or heavy lifting.


If you have CKD, you are likely to experience lethargy and feel exhausted even after sleeping for 8 hours at night. Fatigue often is present when advanced kidney failure develops, but sometimes it can occur before any noticeable decline in kidney function has occurred. The reason for the fatigue is not clearly understood, but it may be related to low blood pressure, anemia, or abnormalities in your hormone levels.

Swelling (edema):

Swelling of your feet and ankles is due to excess fluid building up in your tissues because the kidneys aren’t removing enough water from your blood. This symptom can occur at any stage of kidney disease, but it is more likely to happen when stage 4 CKD has developed.

Eating problems :

People with CKD may develop a strong desire to eat large quantities of food known as polyphagia. At the same time, they are losing appetite and experiencing nausea because their bodies aren’t getting enough nutrition to sustain themselves.

Loss of appetite (anorexia):

Even when you feel like eating large amounts, your body might not be able to absorb enough nutrients from food due to organ damage or other health problems present in late-stage kidney failure. You also may lose your sense of smell or taste if the kidneys fail altogether.

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