Kidney disease affects around 37 million people in the United States.¹ However, as many as 90% don't know they have it until symptoms appear. Early detection and treatment can delay the progression of the disease and prevent kidney failure.
When a nephrologist (kidney doctor) diagnoses kidney disease, they identify its stage by running blood and urine tests. Stage 5 is the last stage of kidney disease. At this point, the kidney damage is severe, and treatment options may be limited.
Let's take a closer look at stage 5 kidney disease life expectancy, symptoms, and management.
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Chronic kidney disease² (also known as chronic renal disease or CKD) is a condition where kidney function decreases over time. As the damage to the kidneys progresses, they lose the ability to properly filter waste from your blood. When waste starts building up, you could face such consequences as:
Gout (type of arthritis caused by the buildup of uric acid)
Secondary hyperparathyroidism (overactive parathyroid glands can't maintain the right balance of calcium in your blood)
Anemia (low red blood cell count)
Blood vessel damage
Complications from kidney disease can develop slowly over time. That's why early detection is key to preventing serious health issues.
The key test that evaluates the stage of your kidney disease is a blood test that measures creatinine levels. Creatinine is a byproduct of creatine, a chemical that delivers energy to your muscles. Kidneys remove creatinine from your body. When they are damaged, the levels of creatinine rise.
Doctors use blood test results and a special formula to calculate the extent of kidney damage and get a figure called estimated glomerular filtration rate (eGFR).
Depending on the damage, your CKD falls into one of five stages.
Stage 1 – mild kidney damage, your kidneys work normally, and eGFR is 90 or higher.
Stage 2 – mild kidney damage, your kidneys still work well, and eGFR is 60–89.
Stage 3 (A and B) – mild to severe kidney damage, your kidneys start losing their function, and eGFR is 30–59.
Stage 4 – severe kidney damage, your kidneys lose most of their function, and eGFR is 15–29.
Stage 5 – severe kidney failure, your kidneys are either close to losing their function or lose it completely, and eGFR is less than 15.
Kidney disease usually progresses over time. If you are diagnosed with one of the initial stages, it doesn't necessarily mean you'll get to stage five. It's imperative to follow doctors' recommendations and keep your kidney damage under control.
Stage 5 of CKD is the last stage of chronic kidney disease. At this stage, your kidneys either stop working or get closer to failing. When you experience kidney failure, you are at the end stage of kidney disease (ESKD).
If your kidneys fail, you’ll need dialysis or a kidney transplant to stay alive. Dialysis (also called renal replacement therapy) is a procedure that removes waste and excess fluid from your blood when your kidneys can't do it anymore.
When you are diagnosed with stage 5 chronic renal disease, you need to speak with a nephrologist about your options. They can design an effective treatment plan.
When you are at stage 5 of CKD, and your eGFR is less than 15, you can experience the following symptoms:
Nausea and vomiting
Itching and dry skin
Unexplained weight loss
Changes in skin color (abnormally dark or light)
Problems with concentration
Numbness, tingling, or swelling in hands and feet
Amenorrhea (lack of menstruation)
Swelling in legs or breathlessness on exertion
Since kidneys can't remove waste and fluids from your body properly, they build up in your blood and cause you to feel sick.
Besides filtering waste, your kidneys have other functions, such as regulating blood pressure, producing hormones that make red blood cells, and activating vitamin D. The loss of this function leads to health complications.
When your doctor diagnoses you with stage 5 kidney disease, they can suggest several treatment options.
Dialysis removes waste and fluid from your blood when your kidneys can no longer do it. Doctors recommend it when you lose around 85–90% of your kidney function and eGFR falls below 15.
Many patients start feeling much better after beginning dialysis. They lead a normal life except for the time they have to spend on the procedure.
There are two types of dialysis:
The dialysis machine removes a portion of your blood, runs it through a special membrane, and returns it to your body. To gain access to your blood, the doctor performs a minor surgery on an arm or leg, which creates a tiny entrance to your blood vessels.
There are alternative ways to gain access, which include:
Joining an artery to a vein under your skin to create a fistula (a bigger blood vessel)
Using a plastic tube to join an artery to a vein under your skin (if your blood vessels are insufficient)
Inserting a catheter (a small plastic tube) into a large vein in your neck (this is usually a temporary measure)
In most cases, patients need hemodialysis three times a week. Each procedure lasts around four hours.
PD uses the inside lining of your abdomen or the “peritoneum” as a natural filter. A doctor places a plastic catheter in your belly. During the procedure, the dialysis solution flows through the catheter and stays in your body to absorb excess fluid and waste.
After several hours, you drain the fluid from your body through the same catheter into a special bag. Each fluid exchange takes around 30–40 minutes. You need to do PD four to six times a day.
A kidney transplant is a surgery that removes your damaged kidney and places a healthy kidney from a donor inside your body. One healthy kidney can handle the function of two kidneys.
To receive a donor's kidney, you would usually need to get on a waiting list. In some cases, waiting for a suitable organ can take years. During that time, you have to be on dialysis.
While a kidney transplant can be an excellent replacement for dialysis, not everyone is eligible for it. Some health conditions may prevent you from getting a transplant.
Once you get a transplant, you will need to take medication to ensure your immune system doesn't reject the new kidney.
In addition to the above treatment options, your doctor will likely recommend switching to a kidney-friendly diet, keeping blood sugar levels under control, monitoring your blood pressure, staying active, and quitting smoking.
According to studies,³ people on dialysis face the highest mortality rate within the first six months after starting the procedure. Then mortality begins to improve over the next six months and increases again gradually over the following four years.
The five-year survival rate for patients who are on long-term dialysis is 35%. Meanwhile, the five-year survival rate for transplant recipients is 80%.⁴
These figures don't mean you only have five years or less to live after being diagnosed with stage 5 CKD. They simply reflect the statistics for people who participated in studies.
Meanwhile, according to data from the United States Renal Data System (USRDS),⁵ people with end-stage kidney failure can live for more than 20 years on dialysis and more than 60 years after a transplant.
Life expectancy can depend on many factors, including:
Age – older people have a shorter life expectancy.
Health conditions – such health problems as heart and blood vessel issues could affect life expectancy as dialysis will not cure these issues and can even worsen them.
Gender – more women than men have kidney disease, but men reach kidney failure faster.
The choice of treatment also plays a major role. People who undergo successful kidney transplantation have a higher life expectancy than those who stay on dialysis.
Once you reach end-stage kidney disease and your kidneys stop working, dialysis or a transplant are some options. There is also the option of conservative care, which involves medications for symptom relief only.
Generally, without dialysis or a transplant, life expectancy can vary from a few days to a few weeks. Importantly, dialysis is not curative.
Conservative care may be more appropriate for patients with a poor quality of life where their life expectancy may not improve much on dialysis. They might rather spend their time at home with family than be in and out of a hospital for dialysis.
Stage 5 kidney disease life expectancy depends on several factors, including your choice of treatment, age, health condition, and gender. The five-year life expectancy for patients on long-term dialysis is 35%. After a successful kidney transplant, the five-year life expectancy is 80%.
Working with a nephrologist is the key to extending your life and increasing its quality. If you suspect kidney problems, contact your doctor as soon as possible. For patients with CKD, early detection is integral to increasing life expectancy.
Kidney disease: The basics | National Kidney Foundation
Chronic kidney disease (CKD) | National Kidney Foundation
Chronic kidney disease (CKD) | Medscape
Statistics | University of San Fransico California
Table 2 expected remaining lifetime (years) by age, sex, and treatment modality of prevalent dialysis patients, prevalent transplant patients, and the general U.S. population (2012) based on USRDS data and the national vital statistics report | Springer Link
Health problems caused by kidney disease | American Kidney Fund
Estimating glomerular filtration rate | National Institute of Diabetes and Digestive and Kidney Disease
Stages of kidney disease | American Kidney Fund
End-stage kidney disease | Penn Medicine
Top 5 jobs kidneys do | American Kidney Fund
Dialysis | American Kidney Fund
Peritoneal dialysis | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Kidney transplant | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Kidney-friendly eating plan | American Kidney Fund
Kidney failure risk factor: Gender (Sex) | National Kidney Fund