The aim is to:

1. Slow down the progression
2. Treat underling cause
3. Manage the complications
4. Preperation to fifth stage

Slow down the progression

control blood pressurecontrol blood sugerlow protien diet, less than 0.8 gm per kg, avoid protein starvationkeep away from saltsnever use pain killer except panadoldo not try non medical presecriptionsdo not use Aminoglycosides antibioticsdrink suffecient amount of fluids, to prevent dehydrationAvoid Pickles and spices

Treat underling cause

continue medical treatment

https://kidneydiseaseclinic.net/gfrr/renal%20falure%20stage%20four.php