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Stage 5 chronic kidney disease (CKD)

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In Stage 5 CKD, you have an eGFR of less than 15. You may also have protein in your urine (i.e., your pee). Stage 5 CKD means your kidneys are getting very close to failure or have already failed. Kidney failure is also called end-stage renal disease (ESRD) and end-stage kidney disease (ESKD). If your kidneys fail, you will need to start dialysis or have a kidney transplant to live.
red and blue kidneys

What is Stage 5 CKD?

Stage 5 CKD means that your kidneys are severely damaged and have stopped doing their job to filter waste from your blood. Waste products may build up in your blood and cause other health problems, such as:

High blood pressure
Anemia (not enough red blood cells in your body) 
Bone disease
Heart disease
High potassium 
High phosphorus 
Metabolic acidosis (a buildup of acid in your body)

What are the symptoms of Stage 5 CKD?

You may have these symptoms in Stage 5 CKD if your kidneys begin to fail:

  • Feeling weak and tired
  • Swelling in your arms, hands, legs or feet
  • Making little or no urine
  • Headaches
  • Pain in your lower back
  • Muscle cramps
  • Feeling sick to your stomach or throwing up
  • Feeling less hungry than normal
  • Trouble breathing
  • Changes in your skin color

How can doctors tell my stage of CKD?

To find out what stage of CKD you are in, doctors will do tests, such as:

How can doctors tell what caused my CKD?

To try and find out what caused your CKD, your doctor may do other tests, including:

  • Blood pressure checks
  • Urine tests
  • Imaging tests to take detailed pictures of the inside of your body, such as ultrasound, CT scan or MRI 
  • Kidney biopsy (a procedure where doctors take a small piece of tissue from your kidneys to look at it under a microscope)
  • Genetic testing (if doctors suspect a rare disease or one that runs in your family)

How do doctors treat Stage 5 CKD?

You will need to see a nephrologist (kidney doctor). Your nephrologist will discuss your treatment options, which include:

patient receiving dialysis
  • Dialysis, which is a treatment to clean your blood when your kidneys are not able to. Learn more about the two types of dialysis.
  • A kidney transplant, which is surgery to give you a kidney from someone else's body. Learn more about kidney transplants.

Your doctor will help you decide which treatment is best for you and create a plan to manage your kidney disease. As part of the plan, your doctor may give you medicines to help with your symptoms and other health problems kidney disease can cause, such as diabetes and high blood pressure.

These medicines include:

medicine pills
  • Blood pressure medicines like ACE inhibitors and ARBs (even if you do not have high blood pressure, these medicines can help slow the damage to your kidneys to keep them working well as long as possible)
  • Diabetes medicines to keep your blood sugar at a healthy level (even if you do not have diabetes)
  • Calcium and vitamin D supplements to keep your bones strong
  • Diuretics to help with swelling (these are medicines that help your kidneys get rid of salt and water and make you urinate more)
  • Phosphorus binders, which prevent your body from absorbing phosphorus from foods you eat
  • Erythropoiesis-stimulating agents (ESAs) or iron supplements to help with anemia (i.e., not enough red blood cells in your body)

Your doctor may tell you to stop taking medicines that can damage your kidneys, such as pain medicines called NSAIDs (nonsteroidal anti-inflammatory medicines).

What steps can I take to manage Stage 5 CKD?

At Stage 5 CKD, there is usually no cure and you cannot reverse the damage to kidney function. There are treatment options for kidney failure that can help you live life. 

Your doctor will recommend that you:

  • Have visits with a nephrologist to check your blood levels and overall health.
  • Meet with a dietitian to help you create and follow a kidney-friendly eating plan. Your eating plan may involve limiting certain things to prevent them from building up in your body, such as fluids, potassium, salt (sodium) or phosphorus. Learn more about a kidney-friendly diet for CKD. 
  • Keep your blood pressure at a healthy level. They may prescribe blood pressure medicines like ACE inhibitor and ARBs.
  • Keep your blood sugar at a healthy level if you have diabetes.
  • Be active for at least 30 minutes on most days of the week. This can be anything from walking or riding a bike to swimming or dancing.
  • Quit smoking or using tobacco.

How long can I live with Stage 5 CKD?

How long you may live (your life expectancy) depends on many things, such as:

  • Your age when diagnosed with CKD
  • How well you follow your treatment plan
  • Your overall health
  • Your wishes