Stage 4 kidney disease can be a scary diagnosis. It’s natural to worry that your life could be cut short because of poor kidney function. However, kidney disease doesn’t have to be fatal. Treatment options are available even if the kidneys fail completely, including dialysis and kidney transplants.

There’s no clear-cut answer on how long someone can live with stage 4 kidney disease. It depends on their overall health and how well their chronic kidney disease (CKD) is being managed.

However, one thing is certain: If you have stage 4 kidney disease, it’s critical to take your kidney function monitoring and treatment plan seriously. The choices you make can have a big impact on how long you live and your quality of life.

What Is Stage 4 Kidney Disease?

Chronic kidney disease is grouped into stages based on the extent of kidney damage. It starts at stage 1 and progresses to stage 5, which is the most severe stage. After severe damage and decline in kidney function in stage 4, the next level, stage 5, is considered end-stage kidney disease (ESKD) or kidney failure.

Kidney disease is defined as stage 4 when the estimated glomerular filtration rate (eGFR), a measure of how well your kidneys are filtering your blood, is between 15 and 29. This eGFR value indicates that your kidneys have lost a lot of their function and are not able to filter wastes and excess fluid from your blood efficiently.

At stage 4, a urine test may also show protein in the urine, which is another sign that the kidneys aren’t working well. Your doctor may order other tests, like taking images of the kidneys with advanced techniques or even a kidney biopsy.

The stage of kidney disease gives a general idea of kidney function, but not all forms of kidney disease are the same. For example, complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) are two rare types of kidney disease. They’re related to an overactive or dysfunctional immune system. People with these conditions have different treatment options that will affect their lives in different ways.

Symptoms of Stage 4 Kidney Disease

The kidneys are mainly responsible for filtering waste and excess fluid from the blood. When they’re not functioning great, wastes like creatinine and urea begin to build up in the body — as well as fluid. Common symptoms for stage 4 kidney disease include:

• Changes in how often you urinate
• Foamy, bubbly urine
• Fatigue
• Lower back pain
• Muscle cramps
• Nausea and vomiting
• Poor appetite
• Swollen arms, legs, and face
• Weakness
• Itchy skin
• Confusion and inability to focus (brain fog)
• Shortness of breath

Stage 4 kidney disease can also lead to several related health problems, such as:

• Acidic blood
• Anemia (low red blood cell counts)
• Bone disease
• Heart disease
• Hypertension (high blood pressure)

If you are diagnosed with stage 4 kidney disease, your nephrologist (kidney doctor) will need to monitor your urine and blood closely to watch for potentially dangerous complications. Your urinary albumin-to-creatinine ratio (uACR) can tell your doctor how much protein is lost in the urine, whether your kidney disease is progressing, and if you’re at risk of complications like heart disease. At stage 4, your healthcare team will probably want to see you every three months.

Factors That Determine Life Expectancy

There’s no way to predict exactly how long you can live with stage 4 kidney disease. Every situation is a little different. Many factors affect your life expectancy, including your lifestyle and whether you have other health conditions. In fact, heart disease (not kidney failure) is the biggest cause of death for people with CKD.

In addition, your age, how long you’ve had kidney disease, and how well you follow your treatment plan are all important considerations. Another crucial factor is the amount of protein in your urine. Higher levels pose a greater risk to your safety and health.

When looking at life expectancy statistics, remember that the available data is based on the past. It doesn’t reflect the latest advancements in medical care. It’s possible that with a proper treatment plan, regular monitoring, and a commitment to healthy lifestyle changes, you can live for several years without progressing to kidney failure. Your nephrologist will discuss other treatment options, like dialysis and kidney transplant, if your kidney disease seems to be progressing to stage 5.

How To Preserve Your Kidney Function

Depending on the type of kidney disease you have, different treatment options may be available. Always follow your healthcare provider’s medical advice because they understand your situation best.

A key priority for people with stage 4 kidney disease is to prevent and manage any kidney disease complications and comorbidities (related health problems), especially heart disease. High blood pressure and diabetes can be especially risky for people with kidney disease. If you have these conditions, be sure to monitor them closely. Follow your healthcare professional’s plans to keep them under control.

Maintaining a balanced body weight, not smoking, limiting alcohol, and sticking to specific dietary recommendations from your healthcare provider are critical to staying healthy. Knowing what to eat can be complicated with kidney disease, and following a kidney-friendly diet and fluid-restriction plan on your own can be overwhelming. Ask to speak with a registered dietitian who can offer you individualized support for planning meals.

Talk With Others Who Understand

MyKidneyDiseaseTeam is the social network for people with kidney disease and their loved ones. Members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

What is life with stage 4 chronic kidney disease like for you? What lifestyle changes have you made to preserve your kidney health and slow the disease progression? Share your experience in the comments below, or start a conversation by posting on your Activities page.