Stage 5 chronic kidney disease (CKD), also known as end-stage renal disease (ESRD) or end-stage kidney disease (ESKD), is the most advanced stage of kidney failure. At this point, the kidneys can no longer filter waste, regulate fluids, or support other essential functions, leading to life-threatening complications. To survive long-term, patients must undergo dialysis or receive a kidney transplant. Early intervention and proper management can markedly improve quality of life.*

Recognizing the Symptoms and Impact on the Body

As kidney function declines, waste builds up in the bloodstream, causing various symptoms that affect daily life. Common signs of stage 5 CKD include:

• Loss of appetite, nausea, and vomiting,
• Fatigue, headaches, and trouble concentrating,
• Swelling around the eyes and ankles,
• Changes in skin color and increased pigmentation.

The kidneys also help:

• Regulate blood pressure, 
• Produce red blood cells, and 
• Maintain bone health. 

Without proper treatment, these functions deteriorate, leading to anemia, weak bones, and cardiovascular complications.

Treatment Options: Dialysis and Transplant

To replace lost kidney function, patients must choose between dialysis or a kidney transplant.

• In hemodialysis (HD), your blood is removed and filtered through a machine, then returned to your body. This can be done at a local dialysis center, or at your home with assistance.
• In peritoneal dialysis (PD), a special fluid is inserted into your abdominal lining to filter waste. PD can be performed at home without a care partner, though you will still need storage space for supplies.

For those considering a kidney transplant, a nephrologist can guide them through the process of finding a donor or joining a transplant waiting list.

Dietary Adjustments for Managing CKD

Nutrition plays a key role in managing stage 5 CKD, especially for those on dialysis. A renal dietitian can help you create a personalized meal plan based on individual needs. General dietary recommendations include:

• Controlling phosphorus and potassium intake by limiting certain whole grains, fruits, and vegetables
• Reducing sodium by avoiding processed foods
• Maintaining adequate protein intake to support dialysis needs

Working closely with your nephrologist and dietitian ensures that you receive the best possible care to manage your condition.

*DaVita Kidney Care. (n.d.). Stage 5 of Chronic Kidney Disease. Retrieved from https://www.davita.com/education/kidney-disease/stages/stage-5-of-chronic-kidney-disease 

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