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The final stage of chronic kidney disease (CKD) is referred to as stage 5 CKD, end-stage kidney disease (ESKD), and end-stage renal disease (ESRD). At this stage, your kidneys are about to fail, or you’re already in kidney failure. Your nephrologist will help you decide the right course of action for your treatment plan, whether dialysis and/or a kidney transplant. Here’s what you can anticipate from stage 5 CKD, including life expectancy with and without further treatment.

What is stage 5 kidney disease?

At Stage 5 CKD, your eGFR is at 15 ml/min or less, and you are about to be in or are in kidney failure. When your kidneys fail, waste builds up in your blood, since your kidneys have lost their ability to function. Moreover, the other functions the kidney performs will no longer happen, including:

  • Regulating blood pressure
  • Producing the hormone (erythropoietin) that contributes to making red blood cells
  • Activating vitamin D to maintain good bone health

This stage of kidney disease will make you feel quite sick, and dialysis and/or a kidney transplant will be necessary to live.

What are the symptoms of end-stage renal failure?

Man sitting down with head on table due to tiredness from stage 5 CKD
Extreme fatigue or tiredness is a common symptom of stage 5 CKD.

Common symptoms to have in stage 5 kidney disease, or kidney failure, include:

  • Loss of appetite
  • Nausea or vomiting
  • Headaches
  • Fatigue or tiredness
  • Back pain
  • Difficulty concentrating
  • Itchiness
  • Unable to urinate or urinating very little
  • Swelling (particularly in the ankles and around the eyes)
  • Muscle cramping
  • Trouble breathing
  • Difficulty sleeping
  • Tingling in hands or feet
  • Changes in skin color
  • Increased skin pigmentation

What treatments are available for stage 5 CKD?

If you have not already, you will need to see a nephrologist immediately to determine and start treatment, which will be either dialysis or a kidney transplant. In some instances, a person with ESRD will have both forms of treatment. If your kidneys have failed, you will need to be on dialysis for the rest of your life unless you have a kidney transplant.

  • Dialysis helps clean your blood by removing waste that your kidneys can no longer remove on their own, as well as helping to maintain healthy levels of potassium, sodium, bicarbonate, and other chemicals and control your blood pressure. There are two different types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). You can receive dialysis in a dialysis center or at home.
Surgeon and nurse in operating room performing kidney transplant
With stage 5 CKD, you will eventually need a kidney transplant, or you will need to be on dialysis for the rest of your life.
(This image is from @peoplecreations on @Freepik.)
  • A kidney transplant means you will receive a healthy kidney from a donor. Surgery will be performed to remove your failing kidney and transplant the new healthy kidney in its place. You will need to take anti-rejection medicines post-transplant to prevent your body from rejecting the healthy kidney. Most transplants are successful and last for many years; some people, however, will need multiple transplants in their lifetime.

Neither form of treatment will cure your kidney disease; there is still no cure for CKD. Both of these treatment methods, however, will extend your life expectancy and allow you to maintain a good quality of life.

How long can you live with stage 5 CKD?

  • If you choose to start dialysis treatment, stage 5 kidney disease life expectancy is five to 10 years on average, though “many patients have lived well on dialysis for 20 or even 30 years,” according to the National Kidney Foundation (NKF).
  • If you have a kidney transplant, “[on] average, a living donor kidney can function anywhere between 12 to 20 years, and a deceased donor kidney can improve quality of life for 8 to 12 years,” as stated by Donate Life America, a nonprofit organization dedicated to organ, eye, and tissue donation.

What is the life expectancy for stage 5 kidney failure without dialysis?

Supportive, or palliative, care is the choice to not pursue treatment—in this instance, specifically dialysis. This course of action, however, will only allow you to maintain your quality of life. It will not help with nor extend your life expectancy.

Without dialysis, the life expectancy for stage 5 kidney failure is not a hard and fast answer, as it varies depending on each kidney patient’s unique medical history. Generally, life expectancy without dialysis can be anywhere from days to weeks, which depends on:

  • Amount of kidney function
  • Severity of symptoms
  • Overall medical condition

Without treatment, toxic waste and fluid will build up in your body, and there are medications you can be prescribed to manage this discomfort. You may also use ultrafiltration therapy to remove fluid buildup and, thus, make it easier for you to breathe.

If you or someone you love is currently in stage 5 CKD, Responsum for CKD can provide information, advice, and support, as well as the ability to connect with other CKD patients.

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