In previous entries, we’ve examined symptoms and effects of Stages One and Two of kidney disease, and then Stage Three, where things finally become noticeable and serious. In Stage Four of kidney disease, the symptoms start to be debilitating, and kidney function is severely impaired. In fact, at this stage, there is only 15-29% kidney function. The body may have disguised its condition for quite a while, but now the disease becomes drastically apparent.
The symptoms magnify things that had begun appearing in Stage Three: fatigue increases considerably, the appetite keeps declining, and an earlier phenomenon of itching might become much worse. High blood pressure continues to be problematic, because of course the kidneys have lost much of their capacity to excrete unneeded fluid, so it is retained in the body, making the heart and blood vessels work harder. And the kidneys may have trouble producing erythopoietin, which stimulates blood cell production, so anemia is another problem.
At Stage Four, a cascade of effects may produce other effects, all of which contribute to an increasing weakness and a worsening of symptoms. As the kidneys become less able to filter phosphate, the levels of that electrolyte increase. In turn, this makes it more difficult for the body to absorb calcium. And since it’s the proper interaction of phosphorous and calcium that strengthens bones, bone density itself may gradually decrease. This may produce aching in the bones, but it also leaves the person more prone to fractures, which take longer than usual to heal.
Treatments at this stage are many. Blood pressure is often treated with diuretics, though some of these can play havoc with potassium levels. Anemia can usually be successfully counteracted with drugs resembling erythopoietin. Medications may prevent bone disease, and much of the phosphorous/calcium imbalance can be reduced with diet.
But these are generally stop-gap measures. This is the stage where the patient begins heading in the direction of dialysis, and starts receiving consideration for a possible transplant. While the effects of Stage Four can be mitigated to some extent, the fact remains that the kidneys are so seriously diseased that the body can’t go on forever like this.
Again, it is extremely important to take good, thorough stock of one’s complete health every few months. The symptoms of kidney disease are easy to miss, in the stages when a person might do something about it.