Renal failure stage 5 is a time at which the kidneys can no longer function without renal replacement therapy or dialysis intervention. The organs can degrade over time to a point at which no cleansing of body fluids is present and the kidneys simply are not adequate to the task. For some patients this can take quite a long time; others a much shorter period. There are no absolutes and tests like the GFR rating must be used to track function decline.
High blood pressure and diabetes are two of the main causes of chronic renal failure. High blood pressure can cause damage to the blood vessels in the kidneys, damage that can lead the kidneys to cease functioning and shut down. The symptoms can come about quickly or can be barely noticeable. Prolonged use of codeine, acetaminophen, ibuprofen and aspirin can cause and ultimately hasten chronic kidney disease. Moderate use in a healthy body taking in adequate fluids is harmless and appropriate as pain relief.
Symptoms of renal failure have different presentation for different patients. Some experience no symptoms while others have effects such as weight loss, irritability, headaches, potassium accumulation, higher blood pressure, increased risk of edema and pulmonary edema.
Some people moving into stage 5 renal failure do not show additional symptoms, making creatinine clearance tests essential to determine the extent of renal degradation.
Diagnosis and Treatment
The older term for renal failure stage 5, end stage renal disease, is now referred to as “established chronic kidney disease”. This is the stage at which the kidneys no longer show sufficient function to be left unaided. Dependence is now on one of two dialysis procedural schedules.
A drop below 15 of the glomerular filtration rate (GFR) can indicate end stage renal failure, requiring immediate treatment and dialysis. GFR is a test which can determine the quantity of fluid that is cleansed through the organ. A combination of inulin, creatinine and urea is calculated to determine results of a GFR rating.
At this stage, kidney function must be replaced by artificial means or surgical organ transplant, should the patient be a candidate.
Dialysis treatments are administered by either hemodialysis or peritoneal dialysis. Hemodialysis cleanses the body by way of filtering the blood through an artificial kidney. A fistula, an artery brought to the surface by a minor surgical procedure enables “needling” the intake and return. Peritoneal dialysis cleanses the body by way of the peritoneal cavity, the bag or membrane surrounding the abdominal cavity. Liquid called dialysate is inserted and left for a period of time as it absorbs waste and then is released through a drainage tube in the stomach. There are fewer candidates for this method, but it means the patient is not tied to a hemodialysis schedule. Renal failure stage 5 leaves the body dependent on mechanical filtration of the fluids of the body.
National Kidney Foundation https://www.kidney.org/
Diagnosis and management of chronic kidney disease https://www.library.nhs.uk/PALLIATIVE/ViewResource.aspx?resID=289369&tabID=288