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Stage 4 Chronic Kidney Failure(CRF)

Stage 4 Chronic Kidney Failure is a severe stage of kidney disease with Glomerular Filtration Rate (GFR) falling at 15-30ml/min. The patients have their kidney function severely declined which can cause systemic symptoms. The patients at this stage, on the hand, should take special care for dietary, lifestyle modifications to control the illness condition and avoid burdening kidneys; on the other hand, receive treatments that improve the kidneys and avoid threatening complications.

As kidney function deteriorates, metabolic wastes can accumulate in bloodstream to cause a medical condition called as “Uremia”. As the kidneys can not as effectively produce erythropoietin, a hormone that stimulates production red blood cells, the patients at stage 4 Kidney failure will develop anemia. The kidneys regulate levels of electrolytes, and in stage 4 kidney failure it is common the patients have high potassium, high phosphorus, low calcium, high sodium, etc. High potassium may cause irregular heartbeats, high sodium worsens fluid retention and elevates blood pressure, and elevated phosphorus can cause unhealthy bones.

Symptoms of Stage 4 Chronic Kidney Failure mainly include:

Weakness: Feeling tired is the resulting symptom from anemia in stage 4.

Urination changes: the urine can be foamy with the foams persist there for long time. This can be a sign for elevated protein in urine. Blood in urine can cause the urine dark orange, brown, tea colored or red. A person may also make more or less urine, or visit the toilets more often at night.

Difficulty in falling asleep. Skin itching, restless legs or muscle cramps can keep the patient awake and difficulty falling or staying asleep.

Nausea. Vomiting or feeling nauseated may occur with Chronic Kidney Failure.

Loss of appetite. The patients don’t feel like eating, and often complain of metallic or ammonia taste in their mouth.

Cardiovascular diseases. In stage 4 Chronic Kidney Failure, various factors, including high blood pressure, water and sodium retention, anemia and toxic substances, increase the patients’ risk of developing heart failure, arrhythmia, myocardial damage, etc.

Symptoms in the nerve system. Early symptoms mainly include insomnia, poor concentration and memory decline. In some cases, the patients experience tingling, numbness, coma, insanity, etc.

A patient with stage 4 generally will want blood tests for creatinine, hemoglobin, calcium, potassium and calcium to access how well the kidneys are working and risks of complications. The doctor after evaluating the lab results will recommend best treatment advice. Because diet is an essential part of the treatment, the patient will be referred to a dietitian, and the dietitian will then review the lab results and recommend a meal plan for the individualized illness condition. Eating a proper diet helps to preserve kidney function and the overall health.

Some of the basic dietary tips for stage 4 kidney failure mainly include the follows:

Calculate your protein intake. Proteins are nutrition sources for human body. However, too much proteins are harmful because this will produce more nitrogenous wastes. As is suggested by The Kidney Disease Outcome Quality Initiative(K/DOQI) Nutrition Guidelines, an intake of proteins 0.6g per kilogram per day is beneficial when your Glomerular Filtration Rate(GFR) falls below 25, or approximately 25 remaining renal functions. You will need to consult your doctor how much protein you should eat per day, and remember that at least half of the proteins should come from high-quality sources such as egg white, lean meat, fish, etc.

Restrict your intake of sodium. Too much sodium can cause more fluid to retain. This can make a person swell up or short of breath. A person with stage 4 Kidney Failure should avoid the intake of processed or refined foods and prepare meals with less sodium or sodium ingredients. Most diets start with a goal of 1,500-2,000mg per day or the amount recommended by your doctor.

Maintain healthy body weight. Calculate if you are in ideal weight, and start by consuming adequate calories and exercising regularly.

The intake of cholesterol. Replace saturated fats with unsaturated fats, and make a diet that is low in total fats. This can help to decrease risks of cardiovascular diseases.

Other tips: You will need to restrict the intake of potassium if laboratory results are above normal range. If a patient retains too much fluid, he will need to limit the intake of liquids. Symptoms of fluid retention mainly include swelling in feet, hands, face; high blood pressure and shortness of breath.

Patients at Stage 4 Kidney Failure should take the medicines prescribed by the doctor to control their blood pressure, anemia, and other conditions so as to prolong the health of kidneys. In Stage 4 people may develop further loss of kidney function to the point where dialysis will begin. In addition to the basic management plan to control the progression, proper treatment to help the poorly functioning kidneys could help improve the kidney condition to a better level so that dialysis can be avoided, which may be achievable by combination of western medicines and traditional Chinese herbs.

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