Is stage five chronic kidney failure serious?

Written by Zhou Qi
Nephrology
Updated on September 08, 2024
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Strictly speaking, there is no condition called "chronic renal failure stage five," but there is a term "chronic kidney disease stage five." Chronic kidney disease is divided into five stages based on the glomerular filtration rate (GFR). Stage five chronic kidney disease indicates that the patient's GFR is less than 15 milliliters per minute, which is about 15% of normal kidney function and is essentially equivalent to uremia. Therefore, chronic renal failure or chronic kidney disease stage five is very dangerous and can cause many complications. Moreover, this type of kidney failure is irreversible and incurable, and the patient may need to undergo dialysis or a kidney transplant.

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Written by Zhou Qi
Nephrology
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What medicine is used for chronic renal failure?

The treatment of chronic renal failure primarily requires identifying the cause and treating it accordingly. Chronic renal failure refers to the state in which various diseases damage the kidneys, leading to the destruction of kidney tissue and resulting in the kidneys' inability to adequately excrete metabolic waste, causing an accumulation of such wastes in the body. There are no medications that can directly affect the kidneys, regenerate kidney tissue, and restore kidney function. Currently, medicine cannot achieve this, and there are no specific drugs for the treatment. Therefore, the treatment of chronic renal failure focuses on treating the primary disease to slow the progression of renal failure. For example, chronic renal failure caused by diabetes necessitates the use of insulin to control blood sugar, while patients with hypertension need to use antihypertensive drugs.

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Written by Wu Ji
Nephrology
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Principles of Treatment for Chronic Renal Failure

The principles of treatment for chronic renal failure include early-stage non-dialysis conservative treatment as well as end-stage renal replacement therapy. Non-dialysis conservative treatment includes delaying the progression of kidney damage, which requires treating the primary disease, implementing nutritional support, and controlling factors that accelerate kidney disease progression, such as controlling high blood pressure, proteinuria, and hyperlipidemia. Additionally, it is necessary to eliminate metabolic waste from the body, and maintain the body's water, electrolyte, and acid-base balance. Renal replacement therapy includes hemodialysis, peritoneal dialysis, and kidney transplant therapy.

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Nephrology
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How to test for chronic renal failure?

The examinations for patients with chronic kidney failure are divided into several aspects: First, it is necessary to confirm the presence of chronic kidney failure and assess its severity. This requires blood tests for kidney function, observing levels of blood creatinine and urea nitrogen, and performing endogenous creatinine clearance tests to determine the degree of kidney failure; Second, it is important to determine whether there are complications associated with kidney failure. Therefore, routine blood tests are necessary to check for renal anemia, blood pressure measurements to observe if there is renal hypertension, and blood tests for electrolytes to check for any electrolyte disorders. These patients also need to have their parathyroid hormone levels checked and undergo iron metabolism tests to provide a basis for further treatment.

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Nephrology
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Can chronic renal failure become pregnant?

Although patients with renal failure are not absolutely unable to become pregnant, pregnancy is ultimately a burden on the kidneys. Pregnant patients with renal failure may experience further deterioration of kidney function and may face numerous complications during pregnancy, such as heart failure, severe anemia, etc., which may pose some risks. However, there are still very rare case reports, including successful pregnancies in patients on dialysis for uremia, but the probability of this is extremely small, and the risks involved are too great. Generally speaking, it is not recommended for female patients with chronic renal failure to become pregnant.

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Written by Wu Ji
Nephrology
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Symptoms of chronic renal failure

The clinical symptoms of chronic renal failure vary at different stages. In the compensatory and early decompensatory stages of chronic renal failure, patients may experience no symptoms or only mild discomforts such as fatigue, back pain, and increased nocturia, while a few may suffer from reduced appetite, metabolic acidosis, and mild anemia. The main clinical symptoms include disorders of water, electrolyte, and acid-base balance, presenting metabolic acidosis, sodium retention or hypovolemia, or hyponatremia, along with hyperkalemia. Moreover, there are significant manifestations of excess phosphorus and calcium deficiency. Patients may also experience disruptions in the metabolism of proteins, carbohydrates, fats, and vitamins. Cardiovascular symptoms mainly include hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms can manifest as loss of appetite, nausea, and vomiting. Hematological manifestations may include renal anemia and a tendency to bleed.