Stage 4 Kidney Disease Life Expectancy

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In general, the stage of kidney disease plays a key role in the prognosis and outlook of patients. The good news, the damage usually develops gradually. So if it’s caught early, you can take early treatments and lifestyle changes to slow its progress before becoming advanced (irreversible). How about stage 4 kidney disease life expectancy?

Five stages of chronic kidney disease (CKD)

The stage is classified according to how severe the kidneys get damaged and how well they keep functioning – from stage 1 (very mild damage) to stage 5 (complete kidney failure). Unfortunately, many times there is no specific symptom of this damage until your kidney function was almost gone.

The damage could be asymptomatic (no signs and symptoms) at early stages. Then at later stages, the kidneys need to work harder to filter your blood — In such case, specific symptoms are likely more noticeable.

A variable called eGFR is a standard measure to find out how well the kidneys are functioning. It stands for ‘estimated glomerular filtration rate’. You can get your eGFR number with blood test since it’s calculated from the amount of creatinine in the blood and other factors (such as gender, age, and body size) [1].

The higher number of your GFR means the better your kidneys functioning level – and vice versa. So we can say that as the GFR numbers goes down, the chronic kidney disease gets worse.

Stages eGFR Kidney functioning level
Stage 1 90 or greater Normal kidney functioning level with kidney damage
Stage 2 89 to 60 Mild loss functioning level
Stage 3A 59 to 45 Mild to moderate loss functioning level
Stage 3B 44 to 30 Moderate to severe loss functioning level
Stage 4 29 to 15 Severe loss functioning level
Stage 5 Lower than 15 Complete loss functioning level (kidney failure)

Determining the stage correctly is necessary since each stage calls for different treatment plan. When your healthcare providers know what stage of the kidney functioning level you have, you can get the most appropriate care and treatment to deal with the problem for better outcome.

Stage 4 kidney disease life expectancy

The kidney functioning level can get impaired from many factors and conditions such as a medical condition (e.g. diabetes and hypertension), a physical injury, or something else. Even some lifestyle factors would also contribute to increase the risk, see more here.

The kidneys do lots of things to keep your body in balance and fit. Some of the main ones are as follows [2]:

  1. To filter and remove unnecessary things in the blood.
  2. To regulate important hormones which some are necessary to control blood pressure, make red blood cells, and keep your bones healthy (strong)!
  3. To maintain the balance level of the body’s fluids.

When they are damaged, they are likely to work harder to support the body. If left untreated, this may lead to a failure, a serious condition that usually requires dialysis or kidney transplantation to fix it.

Symptoms of people with stage 4 kidney disease vary. But in general, these may include [3]:

  1. Tiredness and fatigue.
  2. Edema (swelling), fluid retention of extremities.
  3. Shortness of breath.
  4. Changes in urination — e.g. dark or red urine containing blood, foamy urine, more frequent urination, or less urination (less than normal).
  5. Pain arising from the kidneys, read more here!
  6. Changes in taste, metallic taste for example. This may also cause loss of appetite and weight loss.
  7. Certain substance may build up in the blood, causing bad breath.

The disease may also cause muscle cramps, restless legs, sleep problems, nausea, vomiting, nerve problems (tingling in fingers /toes), and difficulty concentrating.

How does chronic kidney disease affect your body?

As mentioned earlier, there are five stages for CKD. The mildest ones are stage 1 and stage 2, in which the kidneys have mild loss functioning level. In these early phases, mild damage has occurred but the kidneys are quite strong to work (though not at their full strength).

When the damage progresses to the stage 3, the kidneys need work harder since their functioning level has been lost by about 50 percent. In such case, you’re at high risk of developing bone problems or hypertension (high blood pressure). Comprehensive treatment plan is necessary to prevent the loss of kidney function from getting worse.

At more advanced phase (stage 4), the damage turns to become more serious (severe). Since it’s very close to stage 5, treatment is more focused to keep the kidney functioning level as optimal as possible.  Also, you need to properly follow your treatment plan in order to reduce the risk of other problems associated with low kidney function (heart disease for example).

At stage 5, your kidney function level is not enough to keep you alive normally. It was gone (failure), that’s why you need dialysis or (if possible) transplantation.

How many years you can live with stage 4 kidney disease?

There is no exact answer or formula that can accurately predict the prognosis and outcome for stage 4 kidney disease. Also, more than one factor can affect life expectancy.

Again the stage is important variable to determine the outlook and prognosis of the disease, but it is not everything. Each case is unique, not just in terms of personality – but also in terms of other factors such as genetics, gender, current health status, and so forth.

In other words, it’s hard to definitely find out how many years you will survive at this stage 4. But if you’re keen to explore this issue, statistical analysis may help (though this also would make no guarantees).

One statistical review with ‘abridged life table’ method suggests that life expectancy statistics for stage 4 kidney disease are as follows [4]:

The chart suggests that a reduction in life expectancy is consistently associated with an increase in age. This applies for both men and women.

Gender has an effect. Life expectancy of people with stage 4 kidney disease (eGFR 15 to 29) is a bit different between men and women (but not significant). At age 40 years for example, women had life expectancy for about 9.1 years – and 10.4 years for men.

Interestingly, the study found that the gap of life expectancy by gender increases clearly for all ages and all stages (except for stage 4, eGFR 15-29) in which it was relatively longer in women than men.

According to this study, women and men participants aged 40 years got:

  1. A life expectancy of 34.6 years (women) and 30.5 years (men) at stage 2 ‘eGFR 60 or higher’.
  2. A life expectancy of 28.7 years and 24.5 years at stage 3A ‘eGFR 45–59’.
  3. A life expectancy of 16.5 years and 14.5 years at stage 3B ‘eGFR 30-44’.

Albuminuria and prognosis of stage 4 kidney disease

Besides GFR variable, doctors may also look for other variables such as albumin.

Albumin is a protein found in your blood, which is required by the body to support several body functions. For examples it’s necessary to help repair body’s tissues, protect the body from infection, and build muscles.

So we can say there is nothing wrong of albuminuria in the body as long as it’s in the blood. But the story is different when it’s found in the urine.

Albumin in the urine (that’s what we call as albuminuria) could be a signal that the kidneys don’t work as well as normal ones. How severe the problem is going to be is equivalent to the amount of albumin found in your urine.

More amounts of albumin in the urine mean more likely for the kidneys with CKD to turn serious or progress to a failure, see the table below (source)!

Albuminuria categories
30 mg /g or lower 30 to 299 mg /g 300 mg /g or higher
Stage 1
Stage 2
Stage 3A
Stage 3B
Stage 4
Stage 5

Colors on the table above represent the risk for the progression of chronic kidney disease to turn into a failure! They are as follows:

  1. Green is low risk (especially if no other markers of kidney disease).
  2. Yellow is moderately increased risk
  3. Orange is high risk level
  4. Red is very high risk level
  5. Deep red is highest risk

The table suggests that abnormal level of albumin in the urine is common in stage 4 kidney disease. And the risk for the disease to become kidney failure increases drastically when albuminuria is 300 mg /g or higher (deep red).

The risk of heart disease with stage 4 kidney disease

Even if patients get treatment and are careful about their health, they are still at risk of developing complications or even the kidneys may still fail.

That’s why comprehensive treatment plan, including good-self management, is necessary for best outcome and prognosis. With this, it’s possible to delay or stop kidney failure to carry a long, fulfilling life more likely.

Treatment plan may include medications, changes in diet, exercise, maintaining body weight, or complementary therapies (if necessary).

At stage 4, the disease may cause other medical conditions throughout the body. Some that have more attention are as follows:

  1. Problems affecting the heart and blood vessels, including high blood pressure.
  2. Low count of red blood cells (anemia).
  3. Bone and mineral problems.
  4. Nutritional health issues, including loss of appetite.

Work with your healthcare provider comprehensively if you have stage-4 kidney disease since you may have some of those problems already! This is very important to prevent or manage these complications as well.

Interestingly, many people with kidney disease (including those with stage 4) don’t die due to kidney failure. Instead, they may die of something else, especially such as heart disease. Why does this happen?

Because, in addition to their kidney dysfunction, people with kidney disease may also have some of the following heart health risk factors: