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 are the symptoms of chronic kidney failure?

Chronic kidney failure generally may have some clinical symptoms, but many patients do not have any discomfort. Some common clinical symptoms mainly include increased urine foam and decreased urine output. Due to the decline in renal function for urine excretion, it can lead to edema, particularly in areas such as both ankles and the face. In the state of renal failure, patients may also experience hyperkalemia and metabolic acidosis. Due to metabolic acidosis, patients might exhibit deep and labored breathing. In the advanced stages of kidney failure, patients may suffer from renal anemia, leading to fatigue and potentially experiencing bone pain and susceptibility to fractures due to renal osteodystrophy.

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Written by Zhou Qi
Nephrology
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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 Zhou Qi
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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Written by Wu Ji
Nephrology
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Causes of Anemia in Chronic Renal Failure

The causes of anemia in chronic renal failure, also known as renal anemia, occur in chronic kidney disease and are related to chronic renal failure. There are multiple reasons for this anemia, such as the lack of raw materials for red blood cell production caused by chronic renal failure, including deficiencies in iron, folic acid, and vitamin B1, shortened lifespan of red blood cells, and blood loss including non-gastrointestinal blood loss. Moreover, uremic toxins including parathyroid hormone can suppress the production of red blood cells in the bone marrow. However, the primary cause is the decreased production of erythropoietin by the kidneys during chronic renal failure.

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Written by Zhou Qi
Nephrology
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Chronic Kidney Failure Various Indicators

In patients with chronic kidney failure, the primary indicator to observe is obviously kidney function. It is essential to regularly monitor the patient's blood creatinine and urea nitrogen levels, which are generally required to be tested every 1 to 3 months when chronic kidney failure is stable. Additionally, urine output should be monitored. If there is a decrease in urine output and swelling occurs, it may indicate that the patient's kidney function is continuously deteriorating. A complete blood count should also be checked to observe changes in the patient's anemia status. Chronic kidney failure often causes hypertension, so blood pressure monitoring is also necessary for these patients. Electrolyte monitoring is important as kidney failure can lead to disturbances in calcium and phosphorus metabolism and subsequent secondary hyperparathyroidism. Therefore, the levels of calcium, phosphorus, and parathyroid hormone also need to be tested.