Navigating Stage 4 Kidney Journey: Insights into Chronic Kidney Disease and Optimizing Kidney Health


As we delve into the intricate realm of stage 4 kidney disease, a critical juncture in the journey of chronic kidney disease (CKD), a myriad of challenges and choices come to the fore. This article aims to shed light on the complexities faced by individuals grappling with severe loss of kidney function and explore the potential pathways towards a balanced life.

The Essence of Stage 4 Kidney Disease

Stage 4 kidney disease emerges as a pivotal moment where kidney function dwindles significantly, reflected by an estimated glomerular filtration rate (eGFR) hovering between 15 and 29. This phase marks the dire need for strategic health management and contemplation of prospective treatments like kidney transplantation and dialysis.

Unmasking Symptoms and Charting a Course

Often silent till later stages, symptoms of stage 4 kidney disease can include –

  • anemia
  • diminished appetite
  • bone issues (CKD-BMD)
  • altered blood levels of vital elements like phosphorous, calcium, and vitamin D

The journey entails adopting a kidney-friendly diet, orchestrated by healthcare professionals, designed to sustain kidney vitality and elongate their efficacy. Although “BigPharma” tends to preach otherwise, my book on CKD has researched otherwise. Together we can apply a reverse gear to the disease, stopping its progress to Stage 5.

Slow down progression of Chronic Kidney Disease & accelerated ageing

68 naturopathic interventions spanning over 14 amazing chapters, supported by hundreds of medical studies published in journals of medicine, biochemistry and nephrology, to improve kidney’s health

Embracing the Guidance of a Nephrologist

The pivotal role of a nephrologist, a kidney specialist, comes to the fore at this stage. Their expertise in CKD serves as a compass, steering patients towards suitable treatment options aligned with their lifestyles. Based on my experience, you need to create a personalised care team for meticulous monitoring and personalized interventions –

  • Primary care doctor / GP
  • A holistic nephrologist .
  • A holistic clinical nutritionist
  • A naturopath

Forging Resilient Support Networks

Bolstering your journey through stage 4 kidney disease necessitates building robust support networks. Leaning on family, friends, and the medical fraternity, you weave a tapestry of encouragement that fuels your perseverance and determination. Believing in scientifically-proven diet, therapies & interventions, should give you enough confidence which indirectly increases your chances for delaying the progression to Stage 5. 

Potential Treatment Horizons

Confronting the prospect of kidney failure demands proactive research into treatment alternatives. Delve into the realm of peritoneal dialysis, in-center or home hemodialysis, and the possibility of a transformative kidney transplant. The pursuit is to align your chosen path with the rhythm of your life.

Ideally we should try our best to halt progression of the disease to the Stage 5 so that one doesn’t have to go through hemodialysis and expensive (& challenging) kidney transplant process.

Deciphering Dialysis Access: A Crucial Choice

If dialysis emerges as a viable option, selecting a dialysis access route becomes paramount. Consulting with your healthcare provider, you explore choices, enabling you to make an informed decision that resonates with your unique circumstances.

Posing Vital Queries to Your Healthcare Provider

The journey towards optimal health involves engaging in meaningful conversations with your doctor. Engage in dialogue about which treatment avenue aligns harmoniously with your lifestyle. Whether considering a kidney transplant or home dialysis, understanding your choices empowers informed decision-making.

Kidney Transplants

A kidney transplant emerges as a beacon of hope, restoring a semblance of natural kidney function. Whether from a living or deceased donor, this transformative procedure ushers in renewed vitality and a renewed lease on life.

Essence of Dialysis

Dialysis, a life-extending procedure, liberates your body from the clutches of toxins and excess fluids, breathing fresh energy into your daily existence. This intricate process, performed with precision, is an embodiment of modern medical marvels.

Although dialysis removes some uremic toxins, the patient undergoing dialysis still faces problems related to the continuing uraemic state such as anaemia, renal bone disease, malnutrition and cardiovascular complications

Our target should be to avoid dialysis unless its absolutely necessary, stalling the progress of CKD. 

Quest for Eligibility: Kidney Transplant Edition

Determining eligibility for a kidney transplant unfolds as a crucial inquiry. Engage in open conversations with your healthcare provider, pondering the nuances of transplant surgery and evaluating if it harmonizes with your individual needs.

Dialysis Access Knowledge

Understanding dialysis access types positions you at the crossroads of decision-making. The location where the dialysis connection takes place plays a pivotal role. Early exploration broadens your scope for placement choices.

Kidney-Friendly Diet

Embarking on a kidney-friendly diet forms a cornerstone in preserving kidney function. By harmonizing protein, potassium, phosphorus, sodium, and fluid intake, guided by a renal dietitian, you compose a gastronomic journey that nourishes both body and soul.

Although many nephrologists & dieticians rightfully restrict certain micronutrients (potassium, phosphorus etc.), these are important nutrients and without trying to rejuvenate (BigPharma thinks it’s not possible) the diseased kidney, just focusing on dietary restriction wouldn’t apply the much-needed reverse gear to the disease. 

Recently in 2009 researchers conducted a randomized trial which included 134 patients with CKD stage 4 and a serum bicarbonate concentration between 16 mmol/l and 20 mmol/l, who were treated with standard therapy or additionally received sodium bicarbonate at the average dose of 1.82 g/day. The authors of the study demonstrated that administration of sodium bicarbonate in CKD patients slows CKD progression measured by GFR reduction, reduces the number of patients requiring renal replacement therapy, and improves nutritional status. 1

Crusade Against Kidney Disease & Ageing (CAKDA) has dedicated an entire chapter on Alkaline Diet in which above research paper was referenced. 

Life Expectancy

The life expectancy in stage 4 kidney disease hinges on an array of elements, from age at diagnosis to concurrent medical conditions. While the cure for kidney damage remains elusive, a proactive stance can deter further deterioration, lending credence to the age-old adage that prevention is better than cure.

The Journey Ahead

The difficult journey through stage 4 kidney disease demands a mix of holistic medical expertise, self-care, and unwavering resilience. Empowerment lies in comprehending the stages, embracing treatment pathways, and fostering a symbiotic relationship with your healthcare providers.

Health with Knowledge

Understand all about the Kidney (the book contains a deep knowledge-base of Kidney’s biochemistry, if you need it to fight against the disease), empower with the knowledge of CKD, understand various stages up to Stage 5, evolving dietary landscapes, latest research, as you navigate your path toward better health.

Your journey through stage 4 kidney disease can be shaped by informed decisions, nurtured by supportive communities, guided by the hands of experts and empowered with latest research. As you chart your course, remember that we are together in this difficult journey. Let’s fight and stop its progression


  1. de Brito-Ashurst I, Varagunam M, Raftery MJ, Yaqoob MM: Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol 2009; 20: 2075-2084.

  2. Lee G. S. (1991). Medical problems in dialysis patients awaiting renal transplantation. Annals of the Academy of Medicine, Singapore, 20(4), 519–523.

Slow down progression of Chronic Kidney Disease & accelerated ageing

68 naturopathic interventions spanning over 14 amazing chapters, supported by hundreds of medical studies published in journals of medicine, biochemistry and nephrology, to improve kidney’s health

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