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Chronic Kidney Disease Stage 4 and 5 involves significant kidney damage and decrease in glomerular filtration rate (GFR). 

Chronic Kidney Disease





Severe kidney damage with significant decrease in GFR

29 - 15 ml/min 


Kidney failure

less than 15 ml/min

Signs and symptoms of chronic kidney diseases develop over time and progresses slowly. Signs and symptoms may be nonspecific. This may include:  

  • fatigue and tiredness

  • fluid retention usually in the extremities (hands, feet, ankles)

  • puffiness around the eyes

  • difficulty breathing

  • changes in your urination (color, amount, frequency)

  • anemia (low red blood cell count)

  • high blood pressure

  • itchy skin

  • decrease appeptite 

  • nausea, upset stomach and poor digestion 

  • poor nutritional health

  • muscle cramps and twitching

  • weak bones and increase risk for bone fractures

  • skin color changes

  • easy bruising and bleeding

  • mental symptoms decrease ability to concentrate, confusion

  • decrease sexual interest

  • changes in your menstrual cycle 

Treatment for CKD Stages 4 and 5

Treatment for CDK Stages 4 and 5 is individual based and varies. Treatment options may include diet modifications and medication, hemodialysis, peritoneal dialysis, kidney transplant, or no treatment. Each of the methods must be looked at for each individual because of the individual disease, physical condition, emotional condition, or family situation. However, you should be aware of all methods and should discuss them with your physician. A long-term treatment plan or program can be developed best suited for you.  

Anemia in Chronic Renal Disease 

In addition to all the functions that your kidney performs, they also make a hormone that controls the production of red blood cells. This hormone is called erythropoietin (EPO). Almost all of your body's EPO is made in the kidneys. In reduced kidney function, the kidneys may not make enough EPO producing cells. When your EPO is low, your body may not make enough red blood cells and as a result you become anemic

Anemia caused by lack of or not enough EPO,  can be treated with EPO injections prescribed by your physicians.  


Anemia cause fatigue and low energy. Anemia may also be caused by low levels of iron, folic acid, and bleeding problems. Consult with your healthcare provider for proper diagnosis and treatment of anemia. 


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