Chronic Kidney Disease - Stage 5

Reviewed by: HU Medical Review Board | Last reviewed: December 2022

The kidneys play many vital roles in keeping the body going. Their main job is to filter waste and extra water and make urine. They also make hormones that help control blood pressure, make red blood cells, and balance calcium and other minerals in your body.1

Chronic kidney disease (CKD) is a health condition in which the kidneys work less well and sometimes quit working at all. CKD is rated in 5 stages. Each stage is determined by a measurement of how well the kidneys are working and whether there is protein in the urine. This measurement is called your GFR, or glomerular filtration rate.2,3

Stage 5 means kidney failure

At stage 5, your GFR is 15 or lower, which means your kidneys are working at 15 percent or less of their normal function. People with healthy kidneys have a GFR of 60 to 100 and no protein in their urine.4

At stage 5, the kidneys are severely damaged and have either stopped working or are close to not working. When the kidneys stop working, it is called kidney failure, end-stage kidney disease, or end-stage renal disease. Renal means involving the kidneys.2

Symptoms of kidney failure

At stage 5, waste that the kidneys can no longer filter out builds up in the body. This condition is called uremia. You might think of this stage as like trash building up in your house because the garbage hauler stopped coming. Symptoms are severe, and many other health problems follow.2

The CKD symptoms that become noticeable and hard to manage at this stage include:3

  • Feeling weak and tired
  • Swelling of the arms, legs, hands, or feet
  • Making little to no pee
  • Headaches
  • Pain in the lower back
  • Muscle cramps
  • Nausea and vomiting
  • Loss of appetite
  • Trouble breathing
  • Changes in skin color

Treatment options for kidney failure

People with stage 5 kidney disease need to see a kidney specialist called a nephrologist and begin treatment right away. At this stage, treatment for kidney failure is complex and requires a large care team.3

Treatment choices for stage 5 kidney disease and kidney failure are:3

  • Dialysis
  • Kidney transplant
  • Conservative management


Dialysis is a treatment in which a machine cleans waste from the blood when the kidneys cannot. There are 2 types of dialysis:5

Hemodialysis is done in a center or at your home. Peritoneal dialysis is done at your home. Each type of dialysis works slightly differently and has different pros and cons. Hemodialysis is the most common treatment for kidney failure in the United States.5,6

Kidney transplant

A kidney transplant is a surgery in which a healthy kidney from another person is placed in your body. Not everyone with kidney failure can qualify to receive a kidney transplant. But it can help those who do qualify live longer with a better quality of life.7

Conservative management

Conservative management is the treatment choice for people who choose not to do dialysis or seek a kidney transplant. This type of care focuses on quality of life and symptom control. It may also be called palliative, nondialytic, or comfort care. Eventually, hospice care will be needed to manage end-of-life care.8

Other necessary treatments

Kidney failure also requires many medicines to control:3

  • Blood pressure
  • Blood sugar (even if you don't have diabetes)
  • Bone disease
  • Swelling
  • Phosphorus, iron, and calcium levels

Your nephrologist may send you to a dietitian who specializes in dialysis and kidney disease. This renal dietitian can help you get proper nutrition and keep you as healthy as possible.3

Life expectancy with kidney failure

How long you can expect to live with kidney failure depends on many factors, including:3

Without treatment, people with stage 5 kidney disease will die.3

Learn more about the other stages of chronic kidney disease:

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