I've been diagnosed as stage 4 ckd after a stone obstructed my remaining kidney. I now have a nephrostomy. I have not had to be on dialysis for 5 months and I was wondering if everything keeps going well- (diet, labs, etc.) could I advance up the scale of disease.. like from stage 4 to stage 3. I've asked this of the nurses and doctors but their answer is, "well, there's always hope....". I want to know the truth if it's not possible. I can't get anyone to commit to a real answer.
If your kidney tissue was damaged during the stone obstruction, it is not likely to repair itself like a torn muscle or skin wound. Generally speaking, damage to internal organs is not reversible, the cells do not regrow or replace themselves and thus the damage is likely permanent.
If all the stone did was block the flow of blood or fluid, and no kidney tissue was damaged, I would expect that whatever kidney function you had pre-stone would return. This is not unlike one's restricted ability to urinate when a kidney stone is blocking all or a portion of the ureter. Once the stone passes, the ureter reopens and urination can occur unimpeded and generally without any permanent tissue damage or loss of function.
I'm a PKD sufferer and I continue to lose kidney function as the cysts in my kidneys grow and displace normal kidney tissue. Shrinking the cysts would reduce the size of my football sized (vs. a man's fist sized) kidneys, but the tissue displaced would not regenerate. Slowing the growth of the cysts would slow the loss of healthy kidney tissue and this is what drugs in trial are targeting. Uncontrolled high blood pressure will aid the growth of the cysts, whereas well controlled normal blood pressure will retard the growth of the cysts. There are other contributors to cyst growth like diet and stress, which can be challenging to manage.