How to effectively manage my stage 4 chronic kidney disease?

Question

Hello doctor,

I have had poorly controlled hypertension and type 2 diabetes for 16 years, and now I am experiencing progressive fatigue, loss of appetite, nausea, and significant leg and ankle swelling. My urine is foamy, I am urinating less frequently, and I am occasionally short of breath. I am terrified of dialysis. My labs showed creatinine 4.5 milligrams per deciliter (mg/dL), a nd estimated glomerular filtration rate (eGFR) is 14 milliliters per minute per 1.73 mitter square. My albumin-to-creatinine ratio is 2,400 milligrams per gram. The doctors say I have chronic kidney disease, stage 4. Please tell me, what to do?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Based on your long history of uncontrolled hypertension and type 2 diabetes, your symptoms and laboratory results (attachments removed to protect the patient’s identity) suggest advanced chronic kidney disease that is close to kidney failure.

A creatinine level of 4.5 milligrams per deciliter (mg/dL) and an estimated glomerular filtration rate (eGFR) of 14 milliliters per minute per 1.73 square meters means your kidneys are functioning at a very low level, and the very high urine albumin-to-creatinine ratio shows severe kidney damage with heavy protein loss in urine.

Your symptoms include.

Fatigue.
Nausea.
Poor appetite.
Swelling in legs and ankles.
Foamy urine.
Reduced urine output.
Shortness of breath.

These are all signs that your kidneys are not removing fluid and toxins effectively. You need urgent review by a nephrologist to slow progression if possible, treat complications like fluid overload and anemia, and start planning for treatments such as dialysis if required.

Although dialysis can feel scary, starting it at the right time can help improve symptoms and overall quality of life, and strict control of blood pressure, blood sugar, salt, and fluid intake is very important at this stage.

I hope this information helps you.

Feel free to ask further queries.

Thank you.