Kidney Disease

Chronic kidney disease (CKD) is divided into 5 stages based on the level of kidney function. Stages are determined through certain tests performed by your doctor, including a test used to calculate the estimated glomerular filtration rate (eGFR), which measures how well your kidneys are cleaning your blood. Kidney disease is a progressive disease, meaning that kidney function can continue to decline over time, eventually resulting in kidney failure.

While there is typically no cure for CKD, there are treatments that can help. Getting tested is important—with early diagnosis and treatment, you may be able to slow progression and keep your kidneys working.

kidney care class


Take our free class and learn how to thrive with kidney disease. We'll explore how kidneys work, kidney-friendly eating, getting support and treatment choices.

Chronic Kidney Disease Stage 4—Late Stage CKD

CKD Stage 4
Severe loss of kidney function, eGFR of 16–29

Possible signs and symptoms: 
Complications such as anemia (low blood iron), high blood pressure (hypertension) and abnormal blood levels of phosphorus, calcium and vitamin D.

Treatment goals: 
  • Control your blood pressure, blood sugar and cholesterol.
  • Prepare for stage 5, also called end stage renal disease (ESRD), by talking about treatment options.
  • Follow a kidney-friendly diet to avoid stress on your kidneys and your body.
  • Learn about the different ways to treat kidney failure.
  • Schedule a procedure to create your access site for dialysis, if appropriate. The access site is where the dialysis equipment will be connected to your bloodstream for hemodialysis or to your abdomen (peritoneal cavity) for peritoneal dialysis.

What you can do: 
  • Stay in touch regularly with your care team, including your primary care physician, nephrologist, nurse practitioner and your counselor, if you have one.
  • Educate yourself and your family as thoroughly as possible about CKD. Learn about treatment options and discuss them with your nephrologist to see what best fits your life. Taking a class on your treatment options can be especially helpful.
  • Lean on your support network—they care about you and want to be there for you as you adjust to the changes CKD brings. You may also want to find a support group of other people living with CKD. Ask your nurse for recommendations.

What to discuss with your doctor: 
  • Talk to your doctor about all of your dialysis options, including home dialysis treatments. Also ask your doctor for convenient dialysis center recommendations and schedule a tour. Getting information and answers now will give you some time to get comfortable with your choices.
  • Talk to your nephrologist to see if a kidney transplant is a good treatment option for you.
  • Discuss supportive care if it's a consideration. Involve your family in the discussion as well.
  • Talk to your doctor about the placement of your access if you're choosing to go on dialysis. Making this decision prior to kidney failure will give you more placement options. Your access site is the location on your body where dialysis equipment can be connected to access your bloodstream for hemodialysis or access your abdomen for peritoneal dialysis.
  • Ask about which foods and drinks are healthiest for you now, and talk about meal and snack ideas.

Learn more about kidney disease stages.


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Dad with kidney disease teaching child to ride bike.


At-home dialysis can offer greater scheduling flexibility, fewer restrictions and better outcomes.