Life expectancy for stage V kidney failure without dialysis is not definitive. However, as toxins accumulate in the body and cause uremia, death is inevitable within a few weeks. Even if death does not occur immediately, quality of life dramatically decreases.
How long a person can live depends on their medical history and other factors, such as:
- Age (chances of survival decreases with advancing age)
- Kidney function (lifespan decreases as kidney function decreases)
- Severity of symptoms
- Coexisting conditions such as diabetes, hypertension, heart disease, and cancer
- Compliance to medications, diet and lifestyle factors
According to the National Kidney Foundation (NKF), with dialysis stage V kidney disease has a life expectancy of 5-10 years, though many patients have lived well for 20-30 years.
What changes occur after stopping dialysis?
During the final days of life, physical and emotional changes may occur:
- Lack of appetite
- Fluid retention
- Sleeping most of the time
- Unusual restlessness
- Disorientation, confusion, and lack of interest in activities
- Inability to recognize familiar faces
- Change in skin color and temperature
- Heavy breathing
What is stage V kidney disease?
Chronic kidney disease (CKD) is divided into five stages based on the estimated glomerular filtration rate (eGFR) scale. A normal GFR range is around 125 mg/dL. Stage V kidney disease occurs when eGFR falls to 15 or less, indicating kidney failure.
Typically, kidneys are responsible for:
- Filtering fluids, electrolytes, minerals out of the body
- Maintaining pH balance
- Regulating blood pressure
- Producing erythropoietin, a hormone that contributes to red blood cell production
- Activating vitamin D for bone strengthening
What causes stage V kidney disease?
The most common cause of stage V kidney disease is diabetes. Constant high sugar levels cause a chemical reaction called glycosylation in the endothelial (inner lining cells) of the glomeruli (kidney filtering units). The sugar molecules react with cell proteins, resulting in inflammation and fibrosis (scarring) in these units, rendering them nonfunctional.p>
Apart from diabetes, other causes of ESRD include:
- High blood pressure
- Polycystic kidney disease
- Nephrotic syndrome
- Glomerulonephritis
- Recurrent urinary tract infections
- Immunoglobulin A nephropathy
- Lupus
- Kidney stones
- Enlarged prostate
- Side effects of medications, such as nonsteroidal anti-inflammatory drugs and antibiotics
- Alcoholism
- Heavy metal toxicity
- Renal stones
SLIDESHOW
See SlideshowHow is stage V chronic kidney disease treated?
While there is no cure available for end-stage renal disease, treatment may extend lifespan and provide better quality of life:
Dialysis: Dialysis involves using a machine that helps filter blood by removing toxic waste products and maintains a healthy level of potassium, sodium, bicarbonate, and other chemicals that control blood pressure. If their kidneys have failed, a person will need to be on dialysis for the rest of their life unless they undergo a kidney transplant. Dialysis extends life expectancy and prevents further damage. The types of dialysis are:
Hemodialysis (HD): Can be performed at home or in a dialysis center.
Peritoneal dialysis (PD): Blood is filtered by using blood vessels in the lining of the abdomen along with a solution called dialysate.
Kidney transplant: Kidney transplant involves receiving a healthy kidney from a living or a deceased donor. Anti-rejection medicines are prescribed to avoid organ rejection.
Diet and lifestyle changes and regular follow-ups can also help increase lifespan:
- Following recommended dietary plans:
- Kidney-friendly diet, prescribed by a dietitian
- Limiting the intake of sodium, phosphorous, potassium, and protein-rich or fat-rich foods
- Exercising regularly
- Sticking to the dialysis schedule as recommended
- Avoiding or quitting smoking
- Limiting alcohol consumption
- Maintaining a good sleep routine
- Controlling blood sugar and blood pressure levels
- Maintaining a healthy body weight
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American Kidney Fund. Stages of Chronic Kidney Disease. https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/stages-of-chronic-kidney-disease/
National Kidney Foundation. Dialysis. https://www.kidney.org/atoz/content/dialysisinfo
Johns Hopkins Medicine. End Stage Renal Disease (ESRD). https://www.hopkinsmedicine.org/health/conditions-and-diseases/end-stage-renal-failure
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