How long can kidney failure stage 4 be controlled by medication alone without deterioration, the specific time cannot be generalized. It is mainly related to the patient’s age and primary disease, if the patient is older, the primary disease is heavier, such as lupus nephritis, it may be deteriorated in about 1 year; if the patient is younger, the primary disease is chronic nephritis, the comorbidities are controlled more stably, the condition may persist in a few years without deterioration. 1.Age: (1) Elderly people suffering from chronic renal failure stage 4 tend to be very serious and need to receive dialysis treatment as soon as possible to maintain their lives, and in general, they can only last for about one year without deterioration. (2) Young people, due to their relatively good physical condition, can appropriately prolong the time of entering dialysis after active and effective treatment, such as controlling blood pressure, correcting anemia, and improving calcium and phosphorus disorders, i.e., their condition may persist for several years without deterioration. If the development of the necessity of dialysis, young patients can improve the autologous arteriovenous endovascular fistula in advance, for the next step of dialysis treatment. 2. Primary disease: If the primary disease is chronic nephritis, hypertensive renal damage, etc., the general condition development is slow, active drug control, may adhere to several years without deterioration; however, if the primary disease is diabetes mellitus, systemic lupus erythematosus nephritis, vasculitis renal damage, multiple myeloma nephropathy, etc., the general condition development is fast, may be about 1 year that the condition is obviously deteriorated, need to carry out renal replacement therapy. For patients with stage 4 renal failure, it is recommended to visit regular hospitals and standardize the treatment under the guidance of physicians.