What are the Symptoms of Stage 4 Chronic Kidney Disease

Chronic kidney disease can be divided into 5 stages according to the severity of renal damages and remaining kidney functions by calculating GFR using the patients' serum creatinine and body weight.

Stage 1-2 is called mild CKD, stage 3 is moderate, stage 4 is severe and advanced CKD and stage 5 is the end stage in which patients will have to rely on renal dialysis or kidney transplant to sustain their lives. Each stage of CKD has different clinical symptoms and complications.

Stage 4 CKD means severely reduced kidney function and decrease of GFR (15-29) and it means patients will have to prepare for dialysis in the near future if not treated timely and properly.

In stage 4, patients will continue to have these symptoms of stage 3 and only they might become more serious. These symptoms include urine changes, renal pains, general ill feeling, fatigue, fluid retention, loss of appetite and sleep problem. Besides, patients will begin to develop some new symptoms and discomforts because of a state of uremia due to the excessive accumulation of metabolic wastes and toxins.

1. High blood pressure. Many stage 4 CKD patients will begin to have increased blood pressure and this is mainly due to retention of water and sodium since the damaged kidney can not balance water and electrolyte and the excessive fluid and sodium can not be discharged. Besides, patients will also suffer from metabolic disorders of other electrolytes such as high blood phosphate and low blood calcium. Proper medicines and diet adjustment can help relieve these symptoms and their complications.

2. Anemia. We know that kidneys have the function of manufacturing erythropoietin which is responsible for producing enough red blood cells. Stage 4 kidneys can not produce enough erythropoietin and this will cause anemia. And that is why stage 4 CKD patients will suffer from general ill feeling, fatigue and paleness.

3. Protein leakage in urine. In stage 4, the kidneys have been severally damaged that the glomeruli can not prevent proteins to pass through and be leaked into urine. Persistent untreated proteinuria will cause inadequacy of protein in the body and lead to hypoalbuminemia and swelling in the feet, ankles and lower legs.

4. Bone problems. Stage 4 CKD patients often feel bone pain and are susceptible to have bone fracture. This is due to abnormal levels of blood calcium, phosphate and other abnormalities.

Besides, stage 4 CKD patients often have digestive symptoms such as nausea, vomiting, loss of appetite and taste change and nervous symptoms such as difficulty in concentrating and numbness in the toes or fingers.