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If kidneys don't work properly, harmful substances build up in the body, blood pressure can rise, and too much fluid can collect in the body's tissues, which leads to swelling, called edema. If your kidneys fail, you will need dialysis or a kidney transplant to take over their job.
Stage 4 CKD, HD: At ckd stage 4, one does not need dialysis. The time before a patient starts on dialysis depends on what the causes for the ckd, how well it is being controlled, e.g. Diabetes or hbp and the age of the patient. The nephrologist (n) treating this patient is in a much better position to answer your question.