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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Does chronic renal failure require dialysis?

Not all cases of chronic renal failure require dialysis. It is only considered when chronic renal failure progresses to an advanced stage, causing severe consequences, and the kidneys are unable to maintain normal body functions, leading to many complications. Generally, when chronic renal failure progresses to its final stage, i.e., uremia, the kidney function is left with about 10% capacity. The body then experiences a disruption in its internal environment, including the accumulation of a large amount of metabolic waste, serious electrolyte disorders, and severe metabolic acidosis. It is at this point that dialysis is considered. In the early stages of chronic renal failure, dialysis is not necessary.

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Written by Zhou Qi
Nephrology
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What should I do about edema from chronic renal failure?

Chronic renal failure often leads to edema, which is a common symptom associated with the decreased ability of the kidneys to excrete water, resulting in significant water retention in the body. There are two treatment options for this disease. First, medication can be used, typically diuretics such as loop diuretics. After administration, the patient's urine output increases, which can help reduce edema. Second, for patients who do not respond well to medication, and in cases where edema leads to heart failure or pulmonary edema, dialysis treatment may be considered. Through dialysis ultrafiltration and dehydration, edema can also be alleviated.

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What is the blood pressure in chronic renal failure?

High blood pressure is a common complication of chronic renal failure, with about 70 to 80 percent of patients experiencing elevated blood pressure. Controlling blood pressure is also an important aspect of the treatment of chronic renal failure. Generally, it is best for such patients to keep their blood pressure below 130/80 mmHg, with systolic pressure below 130 mmHg and diastolic pressure below 80 mmHg. If a patient’s 24-hour urinary protein quantification exceeds 1 gram, the blood pressure control requirements are even more stringent, ideally below 125/75 mmHg. Adequately controlling blood pressure also helps to slow the progression of chronic renal failure.

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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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Can patients with chronic renal failure have sexual intercourse?

Patients with chronic renal failure can have sexual intercourse, but there are prerequisites. Since sexual activity is physically demanding and requires adequate cardiopulmonary function, patients can engage in sexual activity if they do not experience chest tightness or shortness of breath and their blood pressure is well controlled. If there are no obvious symptoms of fatigue, difficulty breathing, or chest tightness during sexual activity, there should be no significant problems. However, since the patients have chronic renal failure, it is advisable to avoid conception unless prepared for pregnancy. Pregnancy can further burden the kidneys in female patients and potentially exacerbate chronic renal failure. Male patients with chronic renal failure may be taking medications that could affect sperm quality. Therefore, contraception should be practiced unless preparations have been made.