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Chronic Kidney Disease: Stage 4

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Kidneys are bean-shaped organs responsible for filtering the blood of impurities. When the kidney's become infected, the waste products collect in the blood making it acidic. The condition is called chronic kidney disease (CKD).

Based on the Glomerular Filtration Rate (GFR), Chronic Kidney Disease is divided into 5 main stages. This article discusses the symptoms of Stage 4 CKD.

Glomerular Filtration Rate
Glomerular filtration rate is the standard used to determine the health of renal organs; that is the body's ability to filter blood of wastes and excess fluids in relation to time. A GFR equal to or above 90mL/min is considered normal. When infection sets in, the GFR begins to decline gradually.


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A person's age, gender and race are taken into account to calculate the GFR and thereby the stage of CKD. Health conditions such as diabetes and high blood pressure increase the chances of renal problems. Persons above 60 years of age are also placed at a higher risk. Race is an important consideration too as the incidents of kidney dysfunction and failure was observed to be greater in individuals of African American origin.

Symptoms of Kidney Disease: Stage 4
Stage 4 and Stage 5 are labeled as End Stage Renal Disease (ESRD). During the 4th stage, the excretory organs function at less than 15% of their normal ability. The GFR drops to 15-29mL/min. This stage is characterized by the following symptoms:

• Fatigue: A person is likely to develop complications such as anemia. Anemia causes a constant feeling of fatigue.
• Edema: The body is unable to process fluids properly. Much of the fluid stays in the body instead of being excreted. It shows up as swelling in the lower legs, primarily around the ankles, around the wrists and as pockets under the eyes. Accumulation of fluid in the lungs causes shortness of breath.
• Changes to Urine (Frequency, color and appearance): There is noticeable increase or decrease in urine output. Urine tends to be dark in color - tea colored, dark orange or brown. It changes in its appearance too. It becomes foamy.
• Pain in the lower back: Back pain is not a very common symptom of Chronic Kidney Disease. However, some do complain of lower back pain.
• Loss of Appetite and Nausea: Persons with CKD develop a metallic taste in the mouth. This causes loss of appetite. They also complain of nausea and vomiting though not persistent.
• Uremic Breath: This is another symptom observed in Stage 4 of the disease. The kidneys cannot process urea so it collects in the blood. The condition is called Uremia. The buildup of urea causes bad breath.
• Weakened nerves: The nerves weaken with age; kidney infections speed up nerve damage. There is decreased sensation in the feet and hands. Some experience a slight tingling sensation. The condition is also characterized by decreased concentration and alertness.

This phase of Chronic Kidney Disease calls for immediate medical attention. If left untreated, it will result in complete functional failure. There is no cure for ESRD. However, peritoneal dialysis and hemodialysis can help increase life expectancy. Kidney transplant is another option.

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