Your kidneys filter waste and extra water out of your blood. They play an important role in balancing the fluid, salts, and minerals in your body too, which helps your cells and organs function properly. When you have stage 5 chronic kidney disease (CKD), your kidneys can’t keep up with this process. That’s why stage 5 kidney disease is also called kidney failure or end-stage kidney disease (ESKD).

Kidney failure and ESKD are daunting terms. Although there is not yet a cure for stage 5 CKD, it’s still treatable. Dialysis and kidney transplant are two treatment options that can ensure your blood is filtered. In this article, we’ll discuss causes, treatments, and life expectancy for people living with stage 5 chronic kidney disease.

Understanding Stage 5 Kidney Disease

Stage 5 kidney disease is the last of five chronic kidney disease stages. A stage 5 diagnosis means serious damage to your kidneys keeps them from doing their job.

One way nephrologists (kidney doctors) find out the stage of your kidney disease is by using a blood test to measure your estimated glomerular filtration rate (eGFR). This tells them how well your kidneys are filtering waste products from your blood. It’s calculated based on a blood test to look for creatinine buildup in your blood, as well as your age and sex.

Someone in stage 1 kidney disease has a normal eGFR of 90 or higher. To be diagnosed with stage 5 chronic kidney disease, your eGFR must be 15 or lower for three months or longer. With an eGFR of 15, your kidneys are only filtering about 15 percent of the waste two healthy kidneys typically would.

Stage 5 Kidney Disease Causes

Many conditions can damage the kidneys over time, eventually leading to stage 5 chronic kidney disease. High blood pressure and diabetes are the two most common causes of chronic kidney disease. Other causes include kidney infections, inflammation of the glomeruli in the kidneys that filter the blood, genetic causes, and autoimmune conditions like lupus. People with rare kidney diseases like complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) can also progress to stage 5 CKD.

Stage 5 Kidney Disease Symptoms

Earlier stages of CKD might not have any noticeable symptoms, but as waste products and fluids start to build up in your blood, the symptoms may begin to appear in stage 3. Once the kidneys begin to fail in stage 5, you might experience:

• Weakness, tiredness, or fatigue
• Headaches
• Low back pain
• Muscle cramps
• Nausea and vomiting
• Less hunger than usual
• Infrequent urination
• Swollen hands, arms, legs, and feet
• Skin darkening or changing color
• Itchy or dry skin
• Bad breath (smells like fish or urine)
• Shortness of breath
• Trouble concentrating (brain fog)

Treating Stage 5 Kidney Disease

The two treatments for ESKD are dialysis and kidney transplant surgery. Talk to your nephrologist about your treatment options, as well as diet and lifestyle changes to make living with stage 5 CKD easier.

Dialysis

Dialysis is a process that performs some of the functions of your kidneys. It can regulate your blood pressure, filter waste and fluid, and help balance fluids and minerals in your body. There are two main types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis

Hemodialysis removes your blood through a vein in your arm and filters the blood through a machine called a dialyzer that acts as an artificial kidney. You can do hemodialysis at a center three times a week, or at home three to seven times a week.

Peritoneal Dialysis

Peritoneal dialysis involves adding a dialysis solution, called dialysate, into the lining of your abdomen. This solution affects blood vessels in the lining of your abdomen, allowing those blood vessels to filter your blood in a similar way to your kidneys. The solution then drains into a bag outside your body. For peritoneal dialysis, you must have a soft tube surgically implanted in your abdomen to add and drain the dialysate.

Dialysis can support you for many years, even decades, but it isn’t a cure for ESKD or kidney failure. It doesn’t replace all of your kidneys’ functions.

Kidney Transplant

Kidney transplant is a surgery that places a functional kidney from a donor into your body to perform normal kidney functions. The new kidney can come from a living donor or from a deceased donor (a willing donor who has died but still had a healthy, functional kidney).

Talk to your nephrologist about possible kidney transplant barriers and how to prepare.

Stage 5 Kidney Disease Life Expectancy

Stage 5 CKD doesn’t yet have a cure, and it can be life-threatening without the proper treatment.

Managing stage 5 kidney disease with dialysis or a kidney transplant can increase your life expectancy. The average life expectancy of people on dialysis is five to 10 years, but it’s possible to live for decades while on dialysis.

Life expectancy with a kidney transplant also varies widely. It depends on the overall health of the person receiving the kidney and the type of donor kidney. On average, kidney transplants from living donors last 20 to 25 years and transplants from deceased donors last 15 to 20 years.

Other factors, like your age, how well you follow your treatment recommendations, and your diet can also affect your life expectancy. Talk to your healthcare team about your life expectancy and how to follow your treatment plan.

Talk With Others Who Understand

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

Do you have stage 5 kidney disease? Have you had a kidney transplant? Share your experience in the comments below, or start a conversation by posting on your Activities page.